We found 20 Medicare Part D Plans in Colorado.
- The average A premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. is $51.70 per month, however the lowest premium is just $5.50.
- The average drug plan A deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share. is $354 per year, but 4 plans have a zero-dollar deductible.
- Medicare rated 35% of all plans available in Colorado 4 stars or higher.
- There are 8 basic benefit plans and 12 enhanced benefit plans.
- A total of 5 plans offer full Social Security's Low-Income Subsidy (LIS) program helps Medicare beneficiaries pay for their Medicare Part D prescription drugs by paying some of the costs. Also known as "Extra Help", beneficiaries who qualify for LIS receive premium... (LIS) for those who qualify.
- There are 2 plans that have additional coverage in the coverage gap phase (aka, "donut hole").
Colorado Medicare Part D Plans
|AARP MedicareRx Preferred||$103.90||$0||Enhanced||No||No||Yes|
|AARP MedicareRx Saver Plus||$44.00||$480||Basic||No||No||No|
|AARP MedicareRx Walgreens||$29.30||$310||Enhanced||No||No||No|
|Anthem MediBlue Rx Plus||$93.90||$0||Enhanced||No||No||No|
|Anthem MediBlue Rx Standard||$66.20||$430||Basic||No||No||No|
|Cigna Essential Rx||$47.30||$480||Enhanced||No||No||No|
|Cigna Extra Rx||$66.70||$100||Enhanced||No||Yes||Yes|
|Cigna Secure Rx||$36.90||$480||Basic||Yes||No||No|
|Humana Basic Rx Plan||$36.80||$480||Basic||Yes||No||No|
|Humana Premier Rx Plan||$78.10||$480||Enhanced||No||No||Yes|
|Humana Walmart Value Rx Plan||$22.70||$480||Enhanced||No||No||No|
|Mutual of Omaha Rx Plus||$101.40||$480||Basic||No||No||No|
|Mutual of Omaha Rx Premier||$33.80||$480||Enhanced||No||No||Yes|
|Wellcare Medicare Rx Value Plus||$68.90||$0||Enhanced||No||No||No|
|Wellcare Value Script||$5.50||$480||Enhanced||No||No||Yes|
Colorado Medicare Part D Plans Have Four Phases
Medicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... are designed to help Medicare beneficiaries pay for their prescription drugs. Some of the cost-sharing concepts of these plans are foreign to new Medicare beneficiaries, so let's look at the four phases.
The Deductible is the First Phase
A Medicare Part D plan's deductible is the amount you pay out-of-pocket before the initial coverage phase begins and the plan begins paying its share. So, if you enroll in a plan with a $225 deductible, you'll spend that much at the pharmacy for your prescriptions. After that amount, you will pay the copay amount only until you reach the A period of time in which you pay higher cost-sharing for prescription drugs until you spend enough to qualify for catastrophic coverage.. Most Medicare prescription drug plans have a deductible, however, many plans exclude Tier 1 drugs from the deductible, which gives you first-dollar coverage on most lower-cost medications.
The Initial Coverage Limit is the Second Phase
The Part D ICL (Initial Coverage Limit) for 2022 is $4.430. During the ICL phase, your Part D plan will cover the majority of your prescription costs. If your prescription costs exceed $4,430 you go into the coverage gap phase ("donut hole")
The Coverage Gap is the Third Phase
After your 2022 gross drug costs have reached $4,330, you will enter the Coverage Gap phase. This is where you will pay 25% of your medication's retail cost. While the price of A generic drug is a prescription medication that has the same active ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs. might not be much different, what you pay for brand-name drugs will be higher (because you're paying 25% of the full price). This will continue until you reach $7,050 in True Out Of Pocket Costs (TrOOP).
Some plans offer additional gap coverage, so look for it on the plan information pages.
Catastrophic Coverage is the Fourth Phase
All Part D plans offer catastrophic coverage once you have paid $7,050 out-of-pocket for covered drugs. This amount includes the cost of covered drugs as well as some additional costs. In the catastrophic coverage phase, your A copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. or Coinsurance is a percentage of the total you are required to pay for a medical service. will be significantly lower for the remainder of the year.
The Out-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. that help you get catastrophic coverage include:
- Your plan's deductible;
- What you paid during the Once you have met your yearly deductible, you will pay a copayment or coinsurance for each covered drug until you reach the initial coverage limit. You will then enter your plan’s coverage gap (aka, “donut... period;
- Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
- The amount paid by others, including family members, most charities, and other persons on your behalf; and
- The amount paid by State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs, and the Indian Health Service.
The Lowest Premium May Not Be the Lowest Overall Cost
Choose from the available Part D Medicare plans carefully, and don't settle on a Part D plan until you know that your most expensive medications are covered at a price you can afford. This information is available in the plan's A formulary is a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Medications not on a plan's formulary are generally not covered.. You'll find links to the formulary information, pharmacy information, and the customer service phone number on each PDP page (above).
IMPORTANT: Identifying the best Medicare Part D Plans for you takes a bit of research. What's best for you is personal and must consider multiple factors, including your regular prescriptions, your health, and your finances.
Did you Know Most Medicare Advantage Plans Include Prescription Benefits?
Your Medicare benefits are flexible, and there's more than one way to get prescription drug coverage. If you want to keep your Original Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage., you can enroll in one of the stand-alone prescription drug plans available in Colorado. The other way to get Part D coverage is to enroll in one of the many Medicare Advantage Plans available in Colorado that include Part D benefits.
Medicare Part D and Supplements Work Together
Medicare does not pay for all of your hospitalization and medical bills. In fact, Original Medicare only covers about 80 percent of your major medical costs. We keep an up-to-date directory of Colorado Medigap Plans, also called Medicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage., with the tools you need to find the best price and coverage. Medicare Part D plans are fully compatible with Colorado Medigap plans.
Medicare Part D for Dual Eligible People in Colorado
In Colorado, if you are eligible for both Medicare and Medicaid (aka, "dual eligible" or "Medi-Medi") you will automatically be enrolled in a Colorado Medicare Prescription Drug Plan and the Social Security Extra Help program. Extra Help pays for most of the costs of your prescriptions if you meet the eligibility requirements. You may also enroll in a plan of your own choosing that better meets your needs. If you qualified for Medicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. before you were eligible for Medicare, contact your local Medicaid office.
Citations & References
- Medicare.gov, "How to get prescription drug coverage", Last Accessed April 28, 2022
- Benefits.gov, "Medicare Prescription Drug Plans", Last Accessed June 1, 2022
- Medicare.gov, "Costs for Medicare drug coverage", Last Accessed June 3, 2022
- Medicare.gov, "Are prescription drugs covered in Medicare Advantage plans?", Last Accessed June 6, 2022
- SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 1, 2022
- CMS.gov, "Landscape Source Files", Last Accessed October 26, 2021
- CMS.gov, "Medicare Part C & D Performance", Last Accessed October 15, 2021
This Medicare Part D plan state information page was last updated on .