Medicare Part D Plans for the Prescriptions You Rely On
Why You Need Part D Coverage
Medicare Part D plans provide prescription drug coverage through private insurers. Original Medicare does not cover most outpatient prescriptions, so many people enroll in a stand-alone Part D plan or choose a Medicare Advantage plan with drug coverage. Enrolling when first eligible helps you avoid the late enrollment penalty. Benevolent Insurance Group Services reviews your medications and preferred pharmacies from Baltimore and Columbia to the Bronx and Astoria, then recommends plans that fit your budget. If you are still comparing all paths, start with Medicare plan options to see how Part D fits with other choices.
How Medicare Drug Plans Work
Plan Structure
Most plans include an annual deductible, an initial coverage phase with copays or coinsurance by tier, a coverage gap often called the donut hole, and then catastrophic coverage. Recent rules mean you typically pay 25 percent in the gap until catastrophic protection begins.
Formularies Matter
Each plan lists covered drugs and tiers for generics, brands, and specialty medications. BIGS runs comparisons so high-cost prescriptions are vetted across multiple plans, including prior authorization and step therapy rules.
Pharmacy Networks
Copays can be lower at preferred pharmacies. If you like a specific store in Towson or near Fordham Road, we will check which plans provide the best pricing at that location. For some clients, mail order can reduce costs and trips.
Comparing Part D Plans by Total Cost
There can be many Part D plans in each state. A low premium does not always mean the lowest overall cost after copays and coinsurance. BIGS calculates total annual cost based on your drug list, preferred pharmacies, and travel patterns between Maryland and New York to identify the best fit. During Annual Enrollment each fall, we offer no-cost checkups so your plan keeps up with changing formularies.
Part D Enrollment Basics
When to Enroll
Enroll when you first get Medicare unless you have other creditable drug coverage. If you lose employer or VA drug benefits later, you may qualify for a Special Enrollment Period without a penalty.
How to Enroll
A licensed BIGS agent can submit your application by phone or online, or you can enroll directly through Medicare. We confirm your medication list and preferred pharmacies so enrollment is accurate.
Penalties
If you go 63 days or more without creditable drug coverage after you are eligible, a Part D penalty can be added to your premium. We help you time changes to avoid gaps.
If you use a Medicare Advantage plan that already includes drug coverage, read about Medicare Advantage plans to see how MAPD works with pharmacies and mail order choices.
Medicare Part D Questions Answered
Does it matter which plan I choose if I only take generics
Yes. Plans price drugs differently. A generic could be free on one plan and a few dollars on another. We compare by medication to find the best value.
What is the donut hole and will I fall into it
The coverage gap is a phase where you pay a larger share after certain spending thresholds. Many people never reach it, but we estimate your risk based on current prescriptions.
Can I change my Part D plan if my medications change
Most changes wait until Annual Enrollment from October 15 to December 7, unless you qualify for a Special Enrollment Period or receive Extra Help. For Extra Help or plan details, you can review agent resources for quick links and guidance.