Best Medicare Part D Plans for Vermont Beneficiaries in 2024

We found the 24 best Medicare Part D Plans in Vermont. Sign-up for 2024 Medicare Part D plan notification HERE.

We also ranked the best Medicare Advantage plans with Part D in Vermont for 2024.

Vermont Medicare Part D Plans Have Four Phases

Medicare prescription drug plans 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

The deductible (up to $505 in 2023) is the amount that you pay before your Medicare Part D plan begins paying its share of the costs. So, if you enroll in a 2023 prescription drug plan with a $480 deductible, you'll spend $480 out-of-pocket before cost-sharing coverage begins. Most Medicare Part D plans have a deductible, but some Medicare Part D plans exclude Tier 1 drugs from the deductible, giving immediate coverage on most generic medications.

The Initial Coverage Limit is the Second Phase

The Part D ICL (Initial Coverage Limit) for 2023 is $4,660. During the ICL phase, your Part D plan will cover the majority of your prescription costs. If your prescription costs exceed $4,660 you go into the coverage gap phase ("donut hole")

Phase 3 is the Coverage Gap

After your gross drug costs have reached $4,660, you will enter the Coverage Gap phase. This is where you will pay 25% of your medication's retail cost. While the price of generic 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 $7,400 in True Out Of Pocket Costs (TrOOP).

Some plans offer additional gap coverage, so look for it on the plan information pages.

Phase 4 is Catastrophic Coverage

Once you've spent $7,400 out-of-pocket you are out of the coverage gap phase and will receive catastrophic coverage. This happens automatically and ensures that you only pay a small amount for all covered drugs for the remainder of the year.

The out-of-pocket costs that help you get catastrophic coverage include:

1. Your plan's deductible;
2. What you paid during the initial coverage limit period;
3. Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
4. The amount paid by others, including family members, most charities, and other persons on your behalf; and
5. 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 formulary. 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.

Medicare Part D is Included in Most Medicare Advantage Plans

Medicare realizes that one type of plan does not suit everyone. That's why there are two ways to get help with your prescription drug costs. All of the Medicare prescription drug plans available in Vermont work with Original Medicare. That's one way to get coverage. But maybe you'd like even more benefits. That's where Vermont Medicare Advantage Plans come in. Most offer Part D coverage.

Using Supplemental Medicare Insurance with Part D

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 Vermont Medigap Plans, also called Medicare Supplements, with the tools you need to find the best price and coverage. Medicare Part D plans are fully compatible with Vermont Medigap plans.

Medicare Part D for Dual Eligible People in Vermont

In Vermont, if you are eligible for both Medicare and Medicaid (aka, "dual eligible" or "Medi-Medi") you will automatically be enrolled in a Vermont 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 before you were eligible for Medicare, contact your local Medicaid office.

Plans Offered

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Centene Corporation, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna-HealthSpring, Humana, Molina Healthcare, Mutual of Omaha, Oscar Health Insurance, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, and UnitedHealthcare.

Citations & References

1. Medicare.gov, "How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan", Last Accessed September 28, 2022
2. Benefits.gov, "Medicare Prescription Drug Plans", Last Accessed September 1, 2022
3. Medicare.gov, "Costs for Medicare drug coverage", Last Accessed September 3, 2022
4. Medicare.gov, "What's Medicare Supplement Insurance (Medigap)?", Last Accessed June 7, 2022
5. SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 1, 2022
6. CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
7. CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023