Medicare Part D
in Las Vegas
Prescription Drug Plans 


​Medicare Part D Can be confusing.
Our Plan Finder tool will look at the Prescriptions you take and find a plan that covers your Meds and has LOW Out-of-Pocket costs.

Medicare Part D ​Prescription Drug Coverage in Las Vegas

Medicare Part D is a federal program that helps individuals with Medicare coverage pay for prescription drugs. It is offered through private insurance companies and requires enrollment, either through a stand alone prescription drug plan or a Medicare Advantage plan with drug coverage. Part D helps cover the cost of both brand-name and generic prescription medications. 
Click on the Button to Learn more about Medicare Part D from Medicare

Drug Coverage Basics

Medicare drug coverage (Part D) helps cover the cost of prescription drugs. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Private insurance companies offer Medicare drug coverage and must follow rules set by Medicare. Each plan can vary in cost and specific drugs covered. Medicare drug coverage is available to anyone with Medicare.

​To join a plan, you must live in that plan’s service area and be a United States citizen or lawfully present in the United States.
You have 2 options for how you get Medicare drug coverage: 
  • A separate Medicare drug plan
    These plans add drug coverage to  Original Medicare, some Medicare Cost Plans, some Private Fee for Service plans, and Medical Savings Account plans. You must have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) to join a separate Medicare drug plan.
  • As part of your Medicare Advantage Plan (Part C) or other Medicare health plan
    These “bundled“ plans include Part A, Part B, and usually Part D.
  • REMINDER:  (If you join a Medicare Advantage Plan that doesn’t offer drug coverage, in most cases, you won’t be able to add a separate Medicare drug plan.) 

Enrolling in Medicare Part D in Las Vegas

Typically, if you qualify for Medicare, you qualify for Part D prescription drug coverage. But it’s important to keep in mind that you may enroll in Part D coverage only in a few specific periods:
​
  • Your Medicare Initial Enrollment Period (IEP): You can enroll in a Part D plan in the 3 months you turn 65, the month of your 65th birthday or 3 months after.
  • The Medicare Annual Enrollment Period (AEP): This runs from Oct. 15 to Dec. 7 every year. During the AEP, you may make changes to your Medicare Part C and Part D coverage. They will take effect on Jan. 1 of the following year.
  • The Medicare Advantage Open Enrollment Period (OEP): This lasts from Jan. 1 to March 31 each year. You may add, drop or change your Part D coverage during this time.
  • Special Enrollment Period (SEP): You may be able to enroll in a new Part D plan if you’re eligible for an SEP. You may qualify for an SEP under certain circumstances, such as if you make changes to a job-based drug coverage plan, or if you have or lose Extra Help.​
Visit our Enrollment page for Additonal Information on General Enrollment Questions

Medicare Part D Benefit Model

The Changing of Medicare Part D

This is Part of the Inflation Reduction Act of 2023

​What will it Mean for You? Whether you have Medicare Part D as part of Your Medicare Advantage Plan with Drugs (MAPD) or You have Medicare Part D as a Separate Part (Standalone) you will need to be aware of these upcoming changes and the Restructuring of Medicare Part D. These changes will go into effect January 2025

$2,100 cap on out-of-pocket costs for drugs covered by your Medicare plan

For Plan Year 2026, your out-of-pocket costs for covered drugs are capped at $2,100. The cap only applies to drugs covered by your Part D plan, so review your plan to make sure your drugs are covered.​

MEDICARE COVERAGE, THE INFLATION DRUG ACT, AND MEDICARE PLANS

PROVISIONS IN THE INFLATION DRUG ACT

The prescription drug provisions in the Inflation Reduction Act of 2022 that aim to lower out-of-pocket costs apply to all Part D plans, including both stand-alone Part D plans and Medicare Advantage Prescription Drug plans. Regardless of whether beneficiaries get their drug coverage from a stand-alone Part D plan or a Medicare Advantage drug plan, they will benefit from these changes.

​CAPPING INSULIN AT $35.00

As of 2023, cost sharing for insulin is now capped at $35 per month per prescription.
All Medicare Part D plans, both stand-alone drug plans and Medicare Advantage drug plans, will be required to charge no more than $35 for whichever insulin products they cover, although plans will not be required to cover all insulin products. Beneficiaries who use a specific insulin product should verify coverage of their product before enrolling in a specific plan.

VACCINE COVERAGE

Also as of 2023, adult vaccines covered under Medicare Part D that have been recommended by the Advisory Committee on Immunization Practices (ACIP) must now be covered at no cost to enrollees.
This change does not impact the small number of vaccines covered under Medicare Part B (such as the flu, pneumonia, and COVID-19 vaccines), many of which were already covered free of cost. Finally, drug companies are now required to pay rebates to the Medicare program if the cost of drugs used by Medicare beneficiaries rises faster than the rate of inflation each year, similar to the rebate system used by the Medicaid program.

CAPPING OF OUT-OF-POCKET COSTS

Additional provisions came into effect at the start of 2024, which include phasing in a cap on out-of-pocket costs for prescription drugs covered under Medicare Part D by eliminating cost sharing above the catastrophic threshold in 2024 and expanding eligibility for full benefits under the Medicare Part D Low-Income Subsidy Program, which assists qualifying beneficiaries with their Part D premiums, deductibles, and cost-sharing expenses.
Starting in 2026, Medicare beneficiaries will pay no more than $2,100 out of pocket for the prescription drugs they take that are covered under Medicare Part D. Other changes to the Medicare Part D program will be introduced in future years.

Having an Issue with Paying for the Cost of a High Priced Drug?
​The Medicare Prescription Payment Plan for 2025 can Help.

Read about it below...

Whats the Medicare Prescription Payment Plan?

The Medicare Prescription Payment Plan is a new payment option in the prescription drug law that works with your current drug coverage to help you manage your out-of- pocket Medicare Part D drug costs by spreading them across the calendar year (January-December).

Starting in 2025, anyone with a Medicare drug plan or Medicare health plan with drug coverage (like a Medicare Advantage Plan with drug coverage) can use this payment option. All plans offer this payment option and participation is voluntary.

If you select this payment option, each month you’ll continue to pay your plan premium (if you have one), and you’ll get a bill from your health or drug plan to pay for your prescription drugs (instead of paying the pharmacy). There’s no cost to participate in the Medicare Prescription Payment Plan.
(Click on the Picture of the Fact Sheet to Download the Overview)

Your Guide To Medicare Drug Coverage

​Click on the picture below to Find out More...

​Help with Drugs Costs in Las Vegas

​What is Extra Help?
How to Get "Extra Help"
Paying for Prescriptions  
(Click on the Picture below to Learn More)
CLICK on the FACT SHEET to find out more about EXTRA HELP