Medicare Part D drug coverage

Original Medicare doesn't include prescription drug coverage. Neither do Medigap (Medicare Supplement insurance) plans. You have Medicare Part D prescription coverage if you are enrolled in:

  • A MAPD (Medicare Advantage + prescription drug) plan, or
  • A plan that only covers Medicare Part D

What Medicare Part D pays for

  • Prescription drugs that you get from a pharmacy, that you take on your own, that are on your plan’s Approved Drug List (formulary) or that are not on the formulary but for which an exception has been granted, and drugs that are not otherwise covered under Medicare Part A or Part B.
  • Some vaccines other than the ones mentioned under Part B. When vaccines are covered by Part D, they are listed in your plan's approved drug list (formulary).
  • Some diabetes supplies: Part D covers insulin, syringes, needles, alcohol swabs and gauze.
  • Some self-administered drugs:  Part D usually covers self-administered drugs received in an outpatient setting.