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Las Vegas Nevada Medicare Part D – Prescription Drug Coverage

Medicare Part D prescription drug coverage, often referred to as Part D, is provided and coordinated by Medicare-approved private insurance companies. Any beneficiary who is eligible for Original Medicare, Part A and/or Part B, and permanently resides in the service area of a Medicare Prescription Drug Plan, can sign-up for Medicare Part D.

Medicare Part D coverage is optional, but if you don’t enroll in Part D as soon as you’re eligible, you might pay a late-enrollment penalty if you enroll later.

Nevada Medicare can provide free personalized assistance and show you a solution that gives you peace of mind, so you can focus on the things you want. Our Customer Care Team stands ready to help you with any topic. Remember our services are always free.

Key Points to Part D – Prescription Drug Plan:

  • Medicare Part D is simply insurance for your medication needs
  • Beneficiaries can enroll in a standalone Part D drug plan that goes alongside your Original Medicare benefits
  • Some Medicare Advantage plans have a built-in Part D drug plan
  • You pay a monthly premium to an insurance carrier for your Part D plan. In return, you use the insurance carrier’s network of pharmacies to purchase your prescription medications. Instead of paying full price, you will pay a copay or percentage of the drug’s cost. The insurance company will pay the rest.

Below is the current Prescription Drugs Statistics in our Nation (according to Kaiser as of 2019):

  • 58% of Seniors are currently taking at least one prescription medicine
  • 27% say they take four or more prescription drugs
  • 35% of those taking 4 or more prescription drugs say it is difficult for them to be able to afford prescription medication
  • 30% claim they did not take any prescription medication as directed due to cost
  • 45 Million beneficiaries have prescription drug coverage through medicare
  • 6 Million are in Stand-Alone Part D plans as a supplement to traditional Medicare
  • 4 Million are enrolled in a Medicare Advantage Prescription Drug Plans



In 2020, Medicare Part D members are facing a relatively large increase in out-of-pocket drug costs before they qualify for catastrophic coverage. This is due to the expiration of the Affordable Care Act provision that constrained the growth in out-of-pocket costs for Part D members by slowing the growth rate in the catastrophic threshold between 2014 and 2019. For 2020, the out-of-pocket spending threshold will increase by $1,250, from $5,100 to $6,350.

Part D members will also face higher out-of-pocket costs in 2020 for the deductible and in the initial coverage phase, as they have in prior years. The standard deductible is increasing from $415 in 2019 to $435 in 2020, while the initial coverage limit is increasing from $3,820 in 2019 to $4,020 in 2020. For costs in the coverage gap phase, beneficiaries will pay 25% for both brand-name and generic drugs, with plans paying the remaining 75% of generic drug costs—which means that, effective in 2020, the Part D coverage gap will be fully phased out. For total drug costs above the catastrophic threshold, Medicare pays 80%, plans pay 15%, and members pay either 5% of total drug costs or $3.60/$8.95 for each generic and brand-name drug, respectively.

Again, enrollment in Medicare Part D plans is voluntary, with the exception of seniors who are eligible for both Medicare and Medicaid and certain other low-income beneficiaries who are automatically enrolled in a prescription drug plan if they do not choose a plan on their own. Unless you have drug coverage from another source that is at least as good as standard Part D coverage also known as “creditable coverage”, you could face a penalty equal to 1% of the national average premium for each month you delay enrollment.

To learn more about how Part D works and what it covers including the 3 levels of assistance programs available to Nevada beneficiaries please go to What is Part D in Learn About Medicare.

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