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Health · Chapter 17 · Parts C & D

Medicare Part D: Prescription Drugs

Definition
Voluntary private drug plans (stand-alone with Original, or built into MA). Each has a formulary — ≥2 drugs per class, ALL drugs in 6 protected classes, tiered cost-sharing (generics cheapest → specialty highest). Late enrollment without creditable drug coverage = 1% of the national base premium per uncovered month, for life (triggered by a gap of 63+ days). After any deductible the insured pays up to 25% until the out-of-pocket cap; then catastrophic coverage pays 100%. Costs can be spread via a monthly payment cap.
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Verified against primary sources · 2026-08-05