Medicare Part D Plans (PDP)

What is Medicare Part D? Medicare Part D is Medicare’s Prescription Drug Coverage. Anthem offers copays as low as $0 for our Prescription Drug Plans (PDPs). And with over 68,000 national pharmacies, you’ll find one close to you. Original Medicare alone doesn’t cover prescription medications but almost everyone needs them, so you can save with Anthem prescription drug plans. There are often different ways to get Part D. You can get drug coverage through our Medicare Advantage Plans, or you can add a plan separately to your Medicare Supplement plan or Original Medicare.

Is a Medicare Prescription Drug Plan right for you?

Yes , the Medicare Part D plan is right for you

You enrolled in Original Medicare, Parts A and B
You’re not receiving any prescription drug coverage through an employer or your union
You’d like help lowering your prescriptions drug costs
You want coverage for prescriptions in the future, even if you don’t take any right now
You have a Medicare Supplement plan or Original Medicare and you need drug coverage to complement your plans

No, the Medicare Part D plan is not right for you

You’re already signing up for a Medicare Advantage Plan that includes drug coverage
Your union, employer, or a former employer is providing you with drug coverage

Compare Your Medicare Part D Plan Options

Anthem offers Medicare Part D plans with excellent coverage, low monthly premiums and low or no deductibles. We have more than 66,000 pharmacies in our network – that’s almost every pharmacy in America. Even better, 24,000 of those are preferred pharmacies we work with to help you save on many prescription drugs.

MediBlue Rx Enhanced Part D Plan*

Lowest premium of all 3 plans

Savings on prescriptions at many preferred pharmacies

$1 to $2 copays for most generic drugs at preferred pharmacies

MediBlue Rx Plus Part D Plan*

$0 deductible

Largest drug list of all 3 plans

Savings on prescriptions at our many preferred pharmacies

$1 to $3 copays for most generic drugs at preferred pharmacies

MediBlue Rx Standard Part D Plan*

Savings on prescriptions at our many preferred pharmacies

$1 to $3 copays for most generic drugs at preferred pharmacies

Get more details and compare Anthem’s MediBlue Rx Part D plans or search for plans in your area today:

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*In Missouri only, MediBlue Rx plans are called Blue MedicareRx Enhanced, Plus and Value plans.

Does Anthem cover your prescriptions?

Use our prescription search tool to check if we cover your medications.

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How do you pay for a Medicare Prescription Drug Plan?

The cost of your Medicare Prescription Drug Coverage can depend on the plan you pick and how much money you make. People with higher incomes pay premiums that are a little higher. Some costs are outlined below or you can learn more about specific Medicare Part D costs. For a closer look at how PDP plans work and what they cover, visit Medicare Part D.

Premium

The bill that you pay every month for your plan. This bill comes from us, but you can usually arrange to have it taken straight out of Social Security.

Deductible

An annual amount of money you need to spend before your plan kicks in to pay for you or help you pay.

Copay/Coinsurance

The percentage or fixed amount that you pay when you get prescriptions filled at the pharmacy.

Coverage Limit

A limit to how much plans can cover in a calendar year. If you reach that limit, you may have to pay for your full medication costs until the end of the year. (Check out exceptions to this limit below.)

Need more help paying for prescription drugs?

You might qualify for more help. A federal program called Extra Help gives you coverage for the premiums, deductibles, copays, and coinsurance expenses of Medicare Part D (drug plan coverage). To qualify, you must be receiving Original Medicare, living in the United States, and your combined income and assets can’t be worth more than a certain amount ($13,640 as an individual or $27,150 when living with your spouse.) If you qualify for Extra Help, you can enroll in Medicare Part D Drug Plans anytime without having to pay any late enrollment fees.

Learning about Prescription Drug Coverage

Here are some terms you might run into with Medicare Prescription Drug Coverage.

Drug Tiers

All the drugs Anthem covers are divided up into pricing tiers. Basically, generic drugs are the lowest tier and are the most affordable, while brand name medications and specialty drugs are in higher tiers that cost more.

Prior Authorization

In order to cover certain prescription drugs, your plan may require your doctor to clear it with us before writing the prescription and let us know that it’s medically necessary for you.

Step Therapy

For some conditions, there are drugs that do the same thing at different prices. With Step Therapy, you and your doctor can agree to try a less expensive drug first, then “step up” to more expensive drugs if that one isn’t working, or if it becomes medically necessary to do so.

Quantity Limits

For safety reasons, your Prescription Drug Plan may limit the amount of a specific drug you can get. If you refill a prescription too soon, or if you’re prescribed an amount above safety standards, your doctor may need to call us before refilling your prescription in order to keep you covered.

Medicare Part D Drug Plan Exceptions

You and your doctor have the right to ask for exceptions to the limits of your drug plan. You can also apply for an exception from step therapy and quantity limits, or for a lower copayment for a specific drug. Talk to your doctor about getting exceptions when you need them.

The Medication Therapy Management Program

The Medication Therapy Management (MTM) Program is a service for Anthem members with multiple health conditions to help you understand your medications and use them safely. The program is designed to help you and your doctor make sure that your medicines are working to improve your health. If you qualify, you’ll be auto-enrolled in the program. To qualify for the MTM program, you must be managing 3 or more chronic health problems, take 8 or more daily medicines and spend a cost amount indicated by Centers for Medicare & Medicaid Services each year on Part D covered medications. If you qualify, you’ll get a comprehensive medication review and can talk to a pharmacist directly. A summary of that review along with an action plan and personal medication list will be sent to you. You can use these to keep track of your medications and to have available when visiting your doctors. At least once every 3 months, you’ll get a review of your medications with your doctors involved if needed. MTM services are provided at no additional cost to you and while you may choose not to participate in the program, we recommended that you make use of this free service.

To Learn More Visit Our MTM Page

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Medicare Part D Drug Plans