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Part D Prescription Drug Coverage

Drug Coverage is Included in Every Peoples Health Plan

All Peoples Health Medicare plans include Medicare Part D prescription drug coverage.

Original Medicare does not include prescription drug coverage. To get it, you need a prescription drug plan such as a Medicare Part D plan. If you don’t get drug coverage when you are first eligible, you may face a penalty if you want to sign up for it later.

Part D plans are available as “stand-alone” plans, not including other Medicare Advantage benefits. Since the introduction of Part D in 2006, the average stand-alone Part D plan premium has increased by 62% — from about $25 per month to about $42 per month.*

With Peoples Health, you don’t have to pay for a separate prescription plan. Part D drug coverage is included in all of our Medicare Advantage plans.

A word of warning: If you are in a Medicare Advantage plan with prescription drug coverage and you sign up for a separate Part D plan, you will be disenrolled from your Medicare Advantage plan.

You cannot be enrolled in two Part D plans at once.

The Part D Coverage Gap – Or “Donut Hole”

The “doughnut hole” is another name for the Part D coverage gap. It’s a period where you’re responsible for a larger percentage of the cost of your drugs. The amounts may change from year to year.

In the 2019 plan year, the gap starts after you and your plan have spent $3,820 and lasts until your out-of-pocket costs reach $5,100. 

In the 2020 plan year, the gap starts after you and your plan have spent $4,020 and lasts until your out-of-pocket costs reach $6,350.

Peoples Health covers all tier 1 and tier 2 generics through the “doughnut hole.”

With Peoples Health, your out-of-pocket costs for tier 1 and 2 generics will not increase when you are in the gap. Members of Peoples Health special needs plans and members of Peoples Health Group Medicare plans are covered for all drugs during the gap.

Extra Help

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you are eligible, you can contact the agencies below.


1-800-MEDICARE (1-800-633-4227)
24 hours a day, 7 days a week
TTY users should call 1-877-486-2048

Social Security Administration

Monday through Friday
7 a.m. to 7 p.m.
TTY users should call 1-800-325-0778

Louisiana Medicaid

Monday through Friday
7 a.m. to 6 p.m.
TTY users should call 1-800-220-5404

Or call Peoples Health, and we will help you find out if you qualify for extra help.

*Henry J. Kaiser Foundation: “Medicare Part D: A First Look at Prescription Drug Plans in 2020,” November 14, 2019.   


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