Medicare Part D in Colorado: Your Guide to Drug Plans in 2025
Healthcare can be complicated, but choosing a Medicare Part D plan in Colorado doesn't have to be. With 16 plans available in 2025, it's natural to feel unsure. That's why we're here - to break down the complexities and help you find the Medicare Part D Coloradoplan that's right for you.
We're here to take you through everything you need to know so you can make an informed, confident decision about your Medicare Part D coverage options.
Basic Medicare Part D Plans
Basic Medicare Part D plans offer essential drug coverage with lower premiums but may have higher out-of-pocket costs for certain medications. The following table links to all basic benefit Part D plans in Colorado.
| Plan Name | Premium/Mo | Deductible | Rating* | |
|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC | $96 | $590 | ||
| Anthem MediBlue Rx Standard | $115 | $590 | ||
| Cigna Healthcare Assurance Rx | $12 | $590 | ||
| Clear Spring Health Value Rx | $9 | $590 | ||
| Humana Basic Rx Plan | $15 | $590 | ||
| SilverScript Choice | $55 | $590 | ||
| Wellcare Classic | $17 | $590 | ||
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Essential Drug Coverage: Basic plans cover a narrower range of medications, focusing on essential, lower-cost drugs. Ensure that your prescriptions are included in the plan’s formulary, as Basic plans may exclude higher-cost or specialty medications.
- Lower Monthly Premiums: Basic plans typically offer lower monthly premiums, making them a cost-effective choice if your medication needs are minimal or if you are primarily taking generic drugs.
- Higher Deductibles and Cost-Sharing: Expect higher deductibles and out-of-pocket costs with Basic plans, especially for drugs not on the preferred list. If your medication needs increase, these costs could add up quickly.
Enhanced Medicare Part D Plans
Enhanced Medicare Part D plans provide broader drug coverage, often at a higher monthly premium. The following table links to all enhanced benefit Part D plans available in Colorado.
| Plan Name | Premium/Mo | Deductible | Rating* | |
|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC | $105 | $0 | ||
| Anthem MediBlue Rx Plus | $151 | $150 | ||
| Cigna Healthcare Extra Rx | $130 | $175 | ||
| Cigna Healthcare Saver Rx | $21 | $590 | ||
| Clear Spring Health Premier Rx | $74 | $590 | ||
| Humana Premier Rx Plan | $143 | $0 | ||
| Humana Value Rx Plan | $64 | $573 | ||
| Wellcare Medicare Rx Value Plus | $117 | $590 | ||
| Wellcare Value Script | $0 | $590 | ||
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Broader Drug Coverage: Enhanced plans generally offer more extensive coverage, including a broader range of brand-name and specialty drugs. This can be crucial if you require medications not covered by Basic plans.
- Higher Monthly Premiums: Enhanced plans may have higher monthly premiums, reflecting the broader coverage and additional benefits. Ensure that the increased premium aligns with your medication needs and overall budget.
- Lower Out-of-Pocket Costs: Although the premiums are higher, Enhanced plans often offer lower deductibles and reduced copayments or coinsurance for certain drugs. This could lead to overall savings if you require several medications.
Extra Help Medicare Part D Plans
Extra Help Medicare Part D plans significantly reduce prescription costs for eligible beneficiaries, offering lower premiums, deductibles, and copayments. This program is not part of Medicare Advantage plans. The following table shows all Extra Help Part D plans available in Colorado.
| Plan Name | Premium/Mo | Deductible | Rating* | |
|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC | $105 | $0 | ||
| AARP Medicare Rx Saver from UHC | $96 | $590 | ||
| Anthem MediBlue Rx Plus | $151 | $150 | ||
| Anthem MediBlue Rx Standard | $115 | $590 | ||
| Cigna Healthcare Assurance Rx | $12 | $590 | ||
| Cigna Healthcare Extra Rx | $130 | $175 | ||
| Cigna Healthcare Saver Rx | $21 | $590 | ||
| Clear Spring Health Premier Rx | $74 | $590 | ||
| Clear Spring Health Value Rx | $9 | $590 | ||
| Humana Basic Rx Plan | $15 | $590 | ||
| Humana Premier Rx Plan | $143 | $0 | ||
| Humana Value Rx Plan | $64 | $573 | ||
| SilverScript Choice | $55 | $590 | ||
| Wellcare Classic | $17 | $590 | ||
| Wellcare Medicare Rx Value Plus | $117 | $590 | ||
| Wellcare Value Script | $0 | $590 | ||
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- Significant Cost Savings: Extra Help plans are designed to lower your prescription drug costs, including premiums, deductibles, and copayments. Compare how much you can save with each plan, as some might offer more substantial reductions based on your specific medications.
- Coverage During the Coverage Gap: With Extra Help, you might receive continued drug coverage through the coverage gap (donut hole). This means your out-of-pocket medication costs could remain consistent throughout the year, providing more predictable expenses.
- Formulary and Drug Tiers: Even with Extra Help, reviewing the plan's formulary and drug tiers is essential to ensure your medications are covered and to understand any potential out-of-pocket costs. LIS plans might still have variations in copayments depending on the tier of your medications.
- Pharmacy Network Access: Some plans may offer lower copayments at preferred pharmacies. Verify that your regular pharmacy is included in the plan's network, or consider switching to a preferred pharmacy to maximize your savings.
- Impact on Plan Choice: If you qualify for Extra Help, it might influence which plans are most beneficial for you. Plans with higher premiums or deductibles that may not be affordable without assistance could become viable options under LIS, offering more comprehensive coverage.
Understanding Medicare Part D Plans
A Part D plan is the go-to coverage for helping you cover prescription drug costs if you're on Medicare. The main difference between this and Original Medicare is that private insurance companies run the show.
This year, you can expect to shell out an average of $462 for deductibles, but 2 plans offer a $0 deductible - music to the ears of those who have regular prescriptions.
A Closer Look at How Medicare Part D Plans Work
Every Medicare Part D plan covers a wide array of medications through a list known as a formulary. A formulary is a catalog of all the drugs a particular plan covers. Since formularies can vary from plan to plan, it’s important to review yours to ensure it includes the prescriptions you rely on.
Each formulary is divided into different "tiers," categorizing medications by cost. Typically, drugs in lower tiers have lower copayments, while those in higher tiers have higher out-of-pocket expenses.
For instance, Tier 1 might include generic drugs with the lowest copayments, while Tier 2 could feature preferred brand-name medications at a slightly higher cost. Tiers 3, 4, and 5 usually encompass brand-name and specialty drugs with steeper prices.
Out-of-pocket costs can fluctuate based on several factors, including the plan you select, the tier your medications fall under, and which coverage phase you’re in—such as the deductible or initial coverage phase.
How to Choose the Right Medicare Part D Colorado Plan
Finding a Medicare Part D plan in Colorado that aligns with your needs requires carefully reviewing various factors. This ensures that your plan provides the right coverage while minimizing out-of-pocket costs.
Monthly Premium
This is the amount you pay each month for your Medicare Part D plan. Think of it like a subscription fee. While it’s tempting to go for the lowest possible premium, remember to factor in deductibles, copayments, and coverage details.
A lower monthly premium often means a higher deductible or more limited coverage. The goal is to find a good balance that won't result in unexpected expenses later.
Annual Deductible
Similar to deductibles with other types of insurance, this is the amount you need to pay out of pocket for covered medications before your Medicare Part D plan starts covering costs. It’s the amount you pay before your insurance kicks in.
If you regularly take prescription medications, opting for a plan with a lower deductible can often lead to greater savings. If you rarely need prescriptions, choosing a plan with a higher deductible might be a better option.
Drug Formulary
Carefully check the plan’s formulary (list of covered medications) to ensure your drugs are on it. Since plans often change their formularies throughout the year, reviewing it during the Annual Enrollment Period is good practice to confirm that your medications are still covered.
Pay special attention to your drug’s tier placement, as this directly impacts the price you'll have to pay.
Pharmacy Network
Most plans have preferred pharmacy networks offering reduced medication prices, potentially saving you significant money. Check that the pharmacies you prefer are in the plan’s network and explore if mail-order pharmacy services are an option. This can be particularly beneficial for maintenance medications.
How Part D Plans Work with Other Parts of Medicare
Medicare Part D offers prescription drug coverage, but how does it work alongside your other Medicare benefits? Let’s break it down for clarity:
Original Medicare (Parts A and B)
With Original Medicare, Part A covers hospital stays, while Part B handles doctor visits and other medical services, including medications administered by your doctor. Part D comes into play by helping cover the costs of the prescription drugs you take at home. Together, these parts provide comprehensive coverage for both medical care and prescriptions.
Medicare Supplement Insurance
Medicare Supplement plans, often referred to as Medigap, help pay for some of the healthcare costs that Original Medicare doesn’t cover, such as copays, coinsurance, and deductibles. However, Medigap plans don’t cover everything.
For example, Medicare Supplements don’t include prescription drug coverage. To get coverage for your medications, you'll need to enroll in a stand-alone Part D plan.
If you take multiple medications, having both a Medicare Supplement plan and a Part D plan can help you manage your costs. Although you’ll pay a monthly premium for each, the added security of comprehensive medical and drug coverage can be well worth it.
Medicare Advantage Plans
Part D works a little differently if you have a Medicare Advantage plan, also known as Part C. Most Medicare Advantage plans include prescription drug coverage, which means your medical and drug coverage are combined under one plan.
However, some Medicare Advantage plans don’t include drug coverage, allowing you to pair the health plan with a separate Part D plan.
Whether you choose Original Medicare with a standalone Part D plan or a Medicare Advantage plan with built-in drug coverage, the key is to find the best fit for your needs. Consider your current prescriptions and budget to help guide your decision and ensure you have health coverage.
Important Dates for Medicare Part D Enrollment
Medicare has designated periods when you can enroll in or update your coverage. Here are the key dates you should know:
The Initial Enrollment Period (IEP) is a seven-month window starts three months before the month of your 65th birthday. It's your first opportunity to sign up for Medicare Part D and avoid any potential late enrollment penalties.
The Annual Enrollment Period (AEP): From October 15th to December 7th each year, you can make changes to your Medicare coverage. This period is ideal for reviewing your current plan and making adjustments based on any changes in your healthcare needs.
The Medicare Advantage Open Enrollment Period occurs every year from January 1st to March 31st for those enrolled in a Medicare Advantage plan. During this time, you can switch to a different Medicare Advantage plan or return to Original Medicare.
To stay informed, don't forget to bookmark our Medicare Enrollment Periods Guide.
Need Help Enrolling in a Colorado Prescription Drug Plan?
Navigating and comparing Medicare Part D plans can sometimes be overwhelming, but help is just a phone call away. The experienced, licensed insurance agents at HealthCompare can assist you by phone at 1-833-748-3201 (Mon-Fri 5am-6pm, Sat 6am-5pm PST).
HealthCompare is ready to answer your questions, compare plans, and guide you through the enrollment process step by step.
Plans Offered Through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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