What is Medicare Part D

Paying for prescriptions shouldn’t feel like a second mortgage. That’s where Medicare Part D comes in. It’s your pathway to affordable medication coverage, and in 2025, the program is better than ever.

In 2025, this plan is getting a major upgrade. Between lower costs, a new spending cap, and better access to vaccines and insulin, there’s a lot to know. This guide breaks it all down and shows you how Absolute Best Insurance can help you get the right Part D plan for your needs and your wallet.

We’ve been helping people across South Florida, everywhere from Tamarac to Micco, for over 20 years. Whether you’re in a city or a quiet neighborhood near the coast, we can help you sort through your Medicare options. And yes, we even make house calls!

Table of Contents

1. FAQs About Medicare Part D
2. What Does Medicare Part D Cover?
3. 2025 Changes to Prescription Coverage
4. Who Is Eligible for Part D?
5. Enrollment Periods and Deadlines
6. Medicare Advantage and Part D
7. Choosing Between Standalone and Bundled Prescription Coverage
8. How Private Insurance Works With Medicare Part D
9. How We Help You Enroll At No Additional Cost
10. Local Help From Broward County to the Space Coast
11. Choosing the Right Medicare Prescription Plan With Confidence

FAQs About Medicare Part D

What is Medicare Part D?

It’s an optional benefit that helps people with Medicare pay for the cost of prescription drugs.

Is it included with Original Medicare?

No. You must enroll separately in a stand-alone plan or in a Part C plan that includes drug benefits.

Is there a coverage gap in 2025?

No. The coverage gap has been removed. Once you spend $2,000 out of pocket, you pay nothing for covered medications.

Are vaccines included?

Yes. All adult vaccines recommended under prescription coverage rules are now covered with no copay.

What Does Medicare Part D Cover?

This plan helps pay for many types of prescription drugs. This includes:

• Generic and brand-name medications
  

• Specialty drugs
  

• Maintenance medications for chronic conditions
  

Each plan uses a list called a formulary. Drugs are organized into cost tiers. The tier determines your copay or coinsurance. Plans may vary, but all must meet Medicare standards for prescription coverage.

2025 Changes to Prescription Coverage

In 2025, several improvements have made Medicare Part D more affordable:

• A new $2,000 annual cap on out-of-pocket drug costs
  

• Monthly payment options through the Medicare Prescription Payment Plan
  

• $35 monthly cap for covered insulin
  

• $0 copay for adult vaccines
  

• The elimination of the “donut hole” or coverage gap
  

• New manufacturer discount rules to replace the old program
  

These changes apply to both standalone plans and drug benefits included in Medicare Advantage. See details at Medicare.gov

“This is a huge relief for many of our clients. Costs are finally more predictable,” says Stacy Murphy, Owner of Absolute Best Insurance.

Who Is Eligible for Part D?

To sign up for a Medicare Part D plan, you must already be enrolled in Medicare Part A and Part B and live in the service area of the drug plan you want to join. This applies whether you’re on Original Medicare or exploring other coverage options.

If you already have a Medicare Advantage plan (Part C) that includes prescription drug coverage, you cannot also sign up for a standalone Part D plan. You can only have one source of drug coverage through Medicare at a time.

People become eligible for Medicare in a few different ways. Most qualify by turning 65. Your initial enrollment period spans seven months; beginning three months before your 65th birthday, continuing through your birth month, and ending three months after. Enrolling late can result in penalties. Others qualify earlier due to a disability, end-stage renal disease (ESRD), or ALS.

Those with disabilities must receive Social Security or Railroad Retirement Board benefits for 24 months. Those with ESRD may qualify for Medicare shortly after starting dialysis or receiving a kidney transplant. ALS patients are automatically enrolled in Medicare the same month their disability benefits begin.

Enrollment Periods and Deadlines

There are a few key times you can enroll:

• Initial Enrollment Period: Starts 3 months before you turn 65 and ends 3 months after
• Annual Enrollment Period: October 15 to December 7 each year
• Special Enrollment Periods: Triggered by events like moving or losing coverage

Missing your window could lead to late penalties that last the lifetime of your coverage.

Medicare Advantage and Part D

Some Part C plans, also called Medicare Advantage, include drug coverage. These bundled plans offer an all-in-one option that may simplify your healthcare.

Many residents near Holmes Regional Medical Center in Melbourne choose these plans for their convenience.

“For some people, a bundled plan just makes more sense,” says Stacy Murphy.

Choosing Between Standalone and Bundled Prescription Coverage

How do you choose between a standalone drug plan and one built into a Medicare Advantage plan?

Standalone Plan May Be Better If:

• You want to keep Original Medicare
  

• You already have good doctor coverage under Part B
  

• You like choosing a separate plan from your preferred Private Insurance provider
  

Bundled Drug Coverage May Be Better If:

• You want one card for everything
  

• You’re interested in extra benefits like dental and vision

In Vero Beach, many clients near Indian River Medical Center prefer bundled plans. In Greenacres, some stick with Original Medicare and add Part D for more flexibility.

How Private Insurance Works With a Part D Plan

All Part D plans are offered by Private Insurance companies. These plans must follow Medicare rules, but can differ in:

• Monthly premiums
• Covered drug lists
• Preferred pharmacies

Your location and prescriptions will affect what plans are available to you.

“The same medication can cost less or more depending on your plan,” explains Stacy. “That’s why letting us review your options is key.”

How We Help You Enroll At No Additional Cost

You don’t need to figure this out alone.

At Absolute Best Insurance, we compare multiple Private Insurance options and help you choose the right one. Our services are free. If you can’t make it to one of our offices, we’ll come to you.

We’ve helped clients from Tamarac to Vero Beach sort through their prescription coverage options. We can help you, too.

Local Help From Broward County to the Space Coast

We serve people across South Florida:

• Tamarac: Near University Hospital
• Deerfield Beach: serving Century Village and nearby neighborhoods
• Greenacres: Close to Jog Road and Lake Worth Road
• Port St. Lucie: Around St. Lucie West and Tradition Medical Center
• Melbourne: Near Holmes Regional Medical Center
• Vero Beach: Convenient to Indian River Medical Center and U.S. 1
• Micco (Sebastian): Close to Sebastian River Medical Center and Little Hollywood

You can visit us or request a home appointment.

Choosing the Right Medicare Prescription Plan With Confidence

With lower costs and better prescription coverage in 2025, it’s a great time to review your plan options. Whether you’re just turning 65 or already enrolled, now is the time to act.

Our team at Absolute Best Insurance can help you compare plans, understand costs, and enroll with confidence.

“We’re here to help you ask the right questions and make smart decisions,” says Stacy Murphy.

We’re ready to help you get the most out of Medicare Part D. Simply click here or give our team a call for a free, no-obligation quote.

Tamarac: (954) 642-2101
Deerfield Beach: (754) 778-8700
Greenacres & Vero Beach: (561) 420-0280
Port St. Lucie & Melbourne: (772) 828-2840
Sebastian (Micco): (772) 321-0813