Anyone looking to have well-rounded health insurance coverage will undoubtedly need to factor prescription drugs into the equation.

While Original Medicare can offer a solid source of foundational healthcare, it does not cover the vast majority of prescription drugs. Though Medicare Advantage plans often include prescription drug benefits, another option for beneficiaries is to enroll in Medicare Part D coverage, which has the potential to provide needed medication and reduced drug costs.

Ready to jump right into your Medicare Part D prescription drug plan search? Try Insurify’s plan-comparison tool! It’s free and easy to use, and it will give you all the tools you need to make an informed healthcare decision.

 

 

What Are the Best Medicare Part D Plans in Maryland?

In total, there are 27 prescription drug plans available to Medicare beneficiaries in Maryland. But before you make a decision, it’s important to take stock of your own medical needs and financial limitations. Most importantly, you’ll need to check a plan’s formulary to make sure it includes the prescription medication that you need. Even if a plan is highly rated, it may not cover essential medication, or you might live outside of the plan’s service area. So be sure to diligently review any plan to make sure it’s right for you.

As a disclaimer, this list is not an endorsement of these Medicare Part D prescription drug plans or their providers but is rather a showcase of Maryland plans with the highest star ratings.

#1 WellCare Classic S4802-079 (PDP)

    • Monthly Premium: $28.30
    • Deductible: $445
    • Tier 1: $0
    • Tier 2: $4
    • Tier 3: $32
    • Tier 4: 33 percent coinsurance
    • Tier 5: 25 percent coinsurance

With a premium of $28.30, this plan will cost at least $339.60 per year, in addition to the fairly standard deductible of $445. Once you’ve paid through the deductible, you’ll have access to extremely low co-pays for the first two tiers and reasonable co-pays/coinsurance rates for the remaining three tiers. This plan earns 4 stars out of 5.

#2 WellCare Value Script S4802-140 (PDP)

    • Monthly Premium: $16.20
    • Deductible: $445
    • Tier 1: $0
    • Tier 2: $8
    • Tier 3: $43
    • Tier 4: 47 percent coinsurance
    • Tier 5: 25 percent coinsurance

With a slightly lower premium than our #1 plan, WellCare Value Script will cost a baseline of $194.40, in addition to a $445 deductible. The first two coverage tiers are fairly cheap; however, subsequent tiers skew toward the more expensive side. This plan earns 4 stars out of 5.

#3 WellCare Wellness Rx S4802-174 (PDP)

    • Monthly Premium: $14.90
    • Deductible: $445
    • Tier 1: $0
    • Tier 2: $8
    • Tier 3: $40
    • Tier 4: 46 percent coinsurance
    • Tier 5: 25 percent coinsurance

With the lowest premium from the WellCare plans on this list, this plan will cost a baseline of $178.80 per year. As with other WellCare plans, this one has a deductible of $445 that will unlock a tier structure similar to #2 on this list. This plan earns 4 stars out of 5.

#4 AARP MedicareRx Preferred S5820-004 (PDP)

    • Monthly Premium: $87.90
    • Deductible: $0
    • Tier 1: $5
    • Tier 2: $10
    • Tier 3: $45
    • Tier 4: 40 percent coinsurance
    • Tier 5: 33 percent coinsurance

The first from AARP on this list, this plan has a hefty monthly premium that’ll cost $1,054.80 per year. However, the plan has no deductible, so you’ll have access to the tiered co-pay/coinsurance rates as soon as the policy is active. This plan earns 3.5 stars out of 5.

#5 AARP MedicareRx Saver Plus S5921-350 (PDP)

    • Monthly Premium: $28.90
    • Deductible: $445
    • Tier 1: $1
    • Tier 2: $7
    • Tier 3: $35
    • Tier 4: 40 percent coinsurance
    • Tier 5: 25 percent coinsurance

This plan reverts to the standard $445 deductible, albeit with a much lower premium of $28.90 ($346.80 annually). One minor plus that sets it apart from the previous plan is the slightly less expensive tier structure. This plan earns 3.5 stars out of 5.

#6 AARP MedicareRx Walgreens S5921-387 (PDP)

    • Monthly Premium: $31.60
    • Deductible: $445
    • Tier 1: $0
    • Tier 2: $6
    • Tier 3: $40
    • Tier 4: 40 percent coinsurance
    • Tier 5: 25 percent coinsurance

With a monthly premium of $31.60, this plan will cost $379.20 per year, in addition to the standard $445 deductible. The co-pay and coinsurance rates in this plan’s tier structure are comparable to others and don’t deviate too much from the other AARP plans. This plan gets 3.5 stars out of 5.

#7 Cigna Secure-Essential Rx S5617-284 (PDP)

    • Monthly Premium: $24
    • Deductible: $445
    • Tier 1: $0
    • Tier 2: $2
    • Tier 3: 18 percent coinsurance
    • Tier 4: 42 percent coinsurance
    • Tier 5: 25 percent coinsurance

The first Cigna plan on our list, this plan keeps with the common $445 deductible, along with a monthly premium of $24. One thing that stands out for this plan is that most of the tiers (with the exception of the first two) function through coinsurance instead of co-pay. With this information, it’s important to keep retail drug costs in mind as you get into Tiers 3 to 5. This plan earns 3.5 stars out of 5.

#8 Cigna Secure-Extra Rx S5617-250 (PDP)

    • Monthly Premium: $57.50
    • Deductible: $100
    • Tier 1: $4
    • Tier 2: $10
    • Tier 3: $42
    • Tier 4: 50 percent coinsurance
    • Tier 5: 31 percent coinsurance

This plan has a somewhat expensive monthly premium of $57.50, costing $690 annually. On the upside, the deductible is only $100, which means that you’ll be able to pay through it in no time. Things do get more expensive as you get into the later tiers, particularly Tier 4 with its 50 percent coinsurance rate. This plan earns 3.5 stars out of 5.

Don’t quite see the plan for you in this list? Try Insurify’s plan-comparison tool! It’ll provide you with detailed plan information, as well as side-by-side comparisons to help you find the right plan for you.

Compare Part D Plans Side-by-Side

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How Much Does Medicare Part D Cost in Maryland?

In Maryland, monthly premiums for Medicare Part D plans can range from $7.30 to $97.50, and the overall average for monthly premiums sits at roughly $32. This means you’re looking to pay an annual baseline average of $384.

There are also multiple prescription drug tiers that can directly impact the overall cost of your medications. Each tier can vary in terms of co-payment or coinsurance rates, and they are as follows:

    • Tier 1: Preferred generic drugs
    • Tier 2: Non-preferred generic drugs
    • Tier 3: Preferred brand-name drugs
    • Tier 4: Non-preferred brand-name drugs
    • Tier 5: Specialty drugs

In addition, Medicare Part D coverage has three phases that can impact overall cost. During the initial coverage phase, you’ll pay for medications according to your plan’s tier structure. Once you’ve reached $4,130 in spending, you enter the plan’s coverage gap (also known as the “donut hole”), which means that you’ll likely be paying more than normal for medications, though it will typically cost no more than a 25 percent coinsurance. Once you’ve spent a total of $6,550 in out-of-pocket costs, you exit the coverage gap and enter what’s known as the catastrophic coverage phase, which ensures that you pay very small co-pay or coinsurance rates for the rest of the year.

What Is Medicare Part D?

Medicare Part D is a function of Medicare coverage that provides beneficiaries with prescription drug insurance and lower out-of-pocket costs for needed medication. Whether you enroll in a stand-alone Medicare Part D plan or through Medicare Advantage (Medicare Part C), both sources of Medicare Part D are provided by private insurance companies that have been approved by the Centers for Medicare & Medicaid Services

If you are enrolled in Original Medicare ( Medicare Part A and Medicare Part B), you will likely need to enroll in a Medicare Part D plan to get coverage for any medication that you receive outside of inpatient or outpatient care centers.

All Medicare Part D insurance plans are required to cover a wide range of drugs that people with Medicare take, as well as drugs in protected classes. While many Medicare Part D plans cover the same range of medications, you should still check the plan’s formulary to see if it includes your needed medication.

Who Is Eligible for Medicare Part D, and How Do I Enroll?

Anyone who is eligible for Original Medicare is eligible to enroll in a Medicare Part D plan. To qualify for Original Medicare enrollment, you must meet one of the following criteria: 

    • Be at least 65 years old and have 10 years of qualifying work
    • Suffer from a specific chronic illness, such as end-stage renal disease (ESRD)
    • Be eligible to receive Social Security or Railroad benefits

To enroll in Medicare Part D, you must first enroll in Original Medicare. During your Initial Enrollment Period, which begins three months before your 65th birth month and ends three months after, you can enroll in a Medicare Part D plan (provided that you’ve received your Medicare number through Original Medicare enrollment). Be sure to enroll during this period, or you could face a late-enrollment penalty, which can significantly increase the overall cost of your health plan. 

Alternatively, you can take advantage of the Open Enrollment Period, which takes place between October 15 and December 7 of each year. During this time, you can sign up for or switch between different plans.

For more details on eligibility and enrollment, visit www.medicare.gov, or call 1 (800) 633-4227. TTY users can contact 1 (877) 486-2048. You can also consult with an insurance agent of your choosing.

 

 

FAQ: Maryland Medicare Part D Plans

Can I have Medicare Supplement Insurance (Medigap) with a Part D plan?

So long as your Medigap plan does not provide prescription drug coverage, you can have a simultaneous enrollment in both Medicare Supplement Insurance and Medicare Part D. If you have a Medigap plan with prescription drug coverage and would like to switch to a Part D plan, you will need to contact your Medigap insurance provider and request that the prescription drug coverage be removed. It’s important to note that once you have waived the Medigap prescription drug coverage, you will not be able to get it back.

Can’t I save money by not enrolling in a prescription drug plan?

You could potentially forgo enrolling in a Medicare Part D plan and save a few bucks. However, if you do end up needing prescription drug coverage after declining to enroll, you will be faced with a penalty fee that you will have to pay every month, as long as you are still enrolled in the Medicare system.

If money is a real issue, you might want to consider signing up for a subsidy program like Extra Help or enrolling in a plan that has an extremely low monthly premium. This way, if you do end up needing medication, you have at least some coverage.

Are Medicare Part D Plans available throughout Maryland?

Technically, yes, though you should always take a look at a plan’s service area, which determines which counties offer the plan. If you live outside of a plan’s service area, then the plan will simply not be available to you. Be sure to only consider plan options that include your county in their service area.

Conclusion: Save Money by Comparing Plans

Highly rated plans are all well and good, but they may not exactly be the answer to your prescription drug coverage questions. Double-check a plan’s formulary, service area, and pharmacy network to make sure you’re not surprised by any gaps in coverage. If you can keep your medical needs and financial limitations in mind while searching for a plan, you’ll have a clear view of what a plan can do for you.

Ready to start sifting through and comparing plans? Make use of Insurify’s plan-comparison tool. With its easy-to-use format and detailed plan information, you’ll have no trouble taking charge of your insurance search!

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Updated May 16, 2021

Originally from Los Angeles, California, Adrian Coto is a writer living in Brooklyn, New York. A graduate of the NYU Creative Writing MFA program, he's worked as a legal assistant, a law school administrator, and now as a copywriter and editor.