Medicare Part D plans are offered by private insurance companies to help cover the cost of prescription drugs. These plans are optional, but if you don’t enroll when you are first eligible, you may face a permanent late enrollment penalty.
Every plan has a “formulary”—a list of covered drugs. It is crucial to check that your specific medications are on the formulary of the plan you choose.
If you go 63 days or more without Part D or other creditable drug coverage (like from an employer) after your Initial Enrollment Period, you may have to pay a penalty. The penalty is 1% of the "national base beneficiary premium" multiplied by the number of uncovered months. You pay this penalty every month for as long as you have Part D.
You pay 100% of drug costs until you meet the annual deductible (Max $545 in 2024).
You pay a copay or coinsurance, and the plan pays the rest. This continues until total drug costs reach a certain limit.
Also known as the 'Donut Hole'. You pay 25% of brand-name and generic drug costs.
After you pay a significant amount out-of-pocket ($8,000 in 2024), you pay $0 for covered drugs for the rest of the year.
Most plans have preferred pharmacies where copays are significantly lower.
Generic drugs are chemically identical to brand names but cost a fraction of the price.
Formularies change every year. Your plan might drop your drug or move it to a higher tier.
We are legally committed to putting your best interest first—always.
Your coverage is customized based on real needs not generic plan options.
We simplify complex options by comparing plans across multiple carriers.
Annual reviews and year-round help when changes or questions arise.
We review your health, prescriptions, doctors, and budget to establish a clear starting point.
We analyze plans across multiple carriers to find the best fit for your needs.
We handle enrollment and continue reviewing your coverage as plans change each year.
See how individuals and families gained clarity, reduced healthcare costs, and chose coverage that truly fits their needs.
We help individuals understand their coverage options and make informed decisions with confidence.
Side-by-side comparisons make it easier to choose coverage that fits health needs and budgets.
Below are answers to the most frequent questions we hear from individuals preparing for or already enrolled in Medicare.
No. You remain enrolled in Medicare. The Advantage plan simply takes over the administration of your benefits and claims. You retain all rights and protections of Medicare.
You cannot be denied coverage or charged more due to your health status. Medicare Advantage plans are 'guaranteed issue' during your valid enrollment periods.
Yes, you can switch back during the Annual Enrollment Period (Oct 15 - Dec 7) or the Medicare Advantage Open Enrollment Period (Jan 1 - Mar 31). However, getting a Supplement plan at that point might require medical underwriting.
Emergency and urgent care are covered nationwide. Routine care depends on your plan type. PPO plans usually offer some out-of-network coverage, while HMOs are generally restricted to your local area.
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