How Part D Plans Work
Every Part D plan has:
01
A formulary
A list of covered drugs, grouped into cost tiers (generic, preferred brand, non-preferred, specialty).
02
A network of pharmacies
Using preferred pharmacies often means lower copays.
01
Cost-sharing rules
You may pay a deductible, then copays or coinsurance.
02
Coverage phases
Initial coverage, coverage gap (“donut hole”), and catastrophic coverage.
Because formularies and costs vary by plan, the same drug can cost much less with one plan than another. That’s why comparing based on your medication list is critical.