Medicare Part D prescription drug coverage
What is Part D prescription drug coverage?
Medicare Part D helps cover costs for your outpatient prescription drugs and some vaccines that aren't covered under Medicare Part A or Part B. Medicare Part D drug plans offer a formulary (list of covered drugs) with set copays. Most plans with Part D have a monthly premium, benefits and drug costs that vary by plan. As of January 1, 2025, your out-of-pocket drug costs won’t exceed $2,000. Once you hit that amount in annual drug spending (excluding UCare’s amount), you pay $0.
Tools and tips to get your medications
Find an in-network pharmacy
In order for your prescription drugs to be covered by your health plan, make sure to get them from in-network pharmacies. Use our search tool to find a pharmacy in your health plan’s network
Mail order pharmacy
To skip the trip to the pharmacy, fill your prescriptions through Costco Mail Order Pharmacy or one of your health plan’s other in-network mail order pharmacies.
Search the Medicare formulary
Also known as the list of covered drugs or drug list, a formulary is a list of drugs, chosen by a team of doctors and pharmacists, that are covered by your health plan. You can also access your prior authorization and formulary exception criteria documents online as you browse the formulary.
Search the formulary
Fill your prescriptions
Once you’ve found an in-network pharmacy, you can choose from three ways to fill your prescription:
- Have your doctor send your prescription to a pharmacy in your plan network
- Take the written prescription to a pharmacy in your plan network
- Use Costco Mail Order Pharmacy
Get help managing your drug costs
Extra Help
You may qualify for Extra Help, a Medicare program that helps pay for your Medicare Part D prescription drug plan costs, monthly premium, coinsurance, deductible and more. The amount of Extra Help you get will determine your total Part D monthly premium as a member of our plan. The UCare Part D premium includes coverage for both medical services and prescription drug coverage in many plan options. You can find out if you qualify for Extra Help by calling:
- 1-800-MEDICARE (1-800-633-4227)
(TTY 1-877-486-2048), 24 hours a day, seven days a week
- The Social Security Administration at 1-800-772-1213
(TTY 1-800-325-0778), 7 am – 7 pm, Monday – Friday
You can also find information on the Medicare and Social Security Administration websites.
2025 Extra Help program premiums
The information below shows your 2025 UCare monthly Part D plan premium if you get Extra Help. This does not include any Medicare Part B premium you may have to pay.
For UCare Medicare (HMO-POS) Part D coverage: Our coverage area is divided into three regions based on counties: North, South and Metro. Find your region below to see the premium costs with Extra Help. Health care premiums can vary depending on the area in which you live.
For UCare Medicare Group Part D coverage: The amount of Extra Help you get will determine your total monthly premium, which varies based on your UCare Medicare Group plan.
UCare Medicare Plans (HMO-POS)
Metro
- Essentials Rx: $9.50
- Complete: $42.70
- Classic: $112.00
- Aware: $0.00
North
- Essentials Rx: $9.50
- Complete: $47.70
- Classic: $170.00
- Aware: $0.00
South:
- Standard: $14.30
- Complete: $91.70
- Classic: $168.00
UCare Advocate and Your Choice plans
UCare Advocate Choice: $0.00
UCare Advocate Plus: $15.00
UCare Your Choice: $0.00
UCare Your Choice Plus: $25.10
Medicare Prescription Payment Plan
The Medicare Prescription Payment Plan is available to members with Part D coverage. This program will allow you to manage your out-of-pocket Part D prescription drug costs by spreading them out across the plan year instead of paying at the pharmacy. You’re most likely to benefit from participating in the Medicare Prescription Payment Plan if you have high drug costs earlier in the calendar year.
Pharmacy resources and programs
View your pharmacy claims
Get an extended-day supply
Medication Therapy Management
Best Available Evidence policy
Coverage determinations, appeals and grievances
Personalized medication adherence calls
Find important documents
Prescription Drug Claim Form (PDF)
Request for Medicare Prescription Drug Coverage Determination Form (PDF)
Request for Redetermination of Medicare Prescription Drug Denial Form (PDF)