Medicare Part D Coverage Examples
If you don’t know someone who has Medicare Part D coverage, or you’re having a hard time picturing how your own coverage would work,
it may be helpful to read a few examples. How exactly do certain financial or health needs align with different Medicare prescription
drug plans’ coverage and benefits? You can find out here.
The below scenarios involve fictional characters and situations that represent how prescription drug coverage could work.
These are not real stories of real people. Additionally, any costs provided are examples. Prescription drug plan costs vary
depending on the provider and plan you choose.
Nancy is 65 and has recently enrolled in Medicare. She is a retired human resource manager and lives with her husband of
40 years, William. Nancy enjoys spending time with her children and grandchildren, boating on the nearby lake, cooking,
and playing the piano.
Nancy was diagnosed with Type 2 diabetes at the age of 57 and, since then, has taken a daily diabetes drug.
Combined with a healthier diet and increased physical activity, Nancy’s drug lays the foundation for managing her diabetes.
After turning 65, Nancy enrolled in a prescription drug plan because she knew she would continue to need prescription
Nancy’s PDP Plan Features
- Discounted price on the diabetes drug Nancy takes
- An affordable monthly premium
- A $0 deductible so the plan begins sharing the cost immediately
- A pharmacy network that includes Nancy’s favorite pharmacy
Nancy’s Monthly PDP Plan Costs
- $29 monthly premium
- $20 copay for every prescription drug she takes
Robert is 66 years old and has been on Medicare for one year. Robert is a retired engineer who is
recently divorced. His son, a personal trainer, has gotten Robert interested in outdoor activities like biking,
swimming, and hiking. Robert also enjoys watching sports and traveling.
Robert hasn’t always been as healthy as he is now. Since his son got him involved in outdoor physical activities,
Robert has lost weight and feels great. He’s even beginning to pay more attention to his diet by avoiding greasy,
high-calorie foods. Robert has needed prescription drugs periodically, but not on a regular basis.
Robert’s PDP Plan Features
- Discounted price on prescription drugs
- $400 deductible
- A low monthly premium. A higher deductible. A pharmacy network that includes Robert’s pharmacy
Robert’s Monthly PDP Plan Costs
- $30 monthly premium
- 20% coinsurance payment per drug