Medicare Part D in Delaware: Your Guide to Drug Plans in 2025
Choosing the right Medicare Part D plan in Delaware can feel like navigating a maze of premiums, deductibles, and formularies. But it doesn’t have to be overwhelming. With 14 different Medicare Part D Delaware plans available, finding one that fits your healthcare needs and budget is completely possible.
We're here to guide you through everything you need to know so you can make a confident, well-informed 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 Delaware.
| Plan Name | Premium/Mo | Deductible | Rating* | |
|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC | $61 | $590 | ||
| Cigna Healthcare Assurance Rx | $54 | $590 | ||
| Clear Spring Health Value Rx | $8 | $590 | ||
| Humana Basic Rx Plan | $68 | $590 | ||
| SilverScript Choice | $47 | $590 | ||
| Wellcare Classic | $11 | $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 Delaware.
| Plan Name | Premium/Mo | Deductible | Rating* | |
|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC | $89 | $0 | ||
| Cigna Healthcare Extra Rx | $99 | $175 | ||
| Cigna Healthcare Saver Rx | $17 | $590 | ||
| Clear Spring Health Premier Rx | $72 | $590 | ||
| Humana Premier Rx Plan | $120 | $0 | ||
| Humana Value Rx Plan | $25 | $573 | ||
| Wellcare Medicare Rx Value Plus | $102 | $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 Delaware.
| Plan Name | Premium/Mo | Deductible | Rating* | |
|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC | $89 | $0 | ||
| AARP Medicare Rx Saver from UHC | $61 | $590 | ||
| Cigna Healthcare Assurance Rx | $54 | $590 | ||
| Cigna Healthcare Extra Rx | $99 | $175 | ||
| Cigna Healthcare Saver Rx | $17 | $590 | ||
| Clear Spring Health Premier Rx | $72 | $590 | ||
| Clear Spring Health Value Rx | $8 | $590 | ||
| Humana Basic Rx Plan | $68 | $590 | ||
| Humana Premier Rx Plan | $120 | $0 | ||
| Humana Value Rx Plan | $25 | $573 | ||
| SilverScript Choice | $47 | $590 | ||
| Wellcare Classic | $11 | $590 | ||
| Wellcare Medicare Rx Value Plus | $102 | $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
First, let's simplify what Medicare Part D is and why it's so important, particularly here in Delaware. Simply put, Medicare Part D is designed to help cover the cost of prescription drugs. Private insurance companies run it, which is a key difference from Original Medicare (Parts A and B).
This year, the average deductible in Delaware for Medicare Part D is $475, but 2 plans offer a $0 deductible, which could translate into significant savings for you. It all depends on your prescriptions.
How Medicare Part D Plans Work
Every Medicare Part D plan covers a wide range of drugs categorized into what’s known as a formulary. Formularies list all the medications covered by that specific plan. Each plan may have different formularies, which is why it’s essential to check and make sure yours includes the prescriptions you need.
Also, every formulary has different “tiers” which categorize medications based on cost. Generally, lower-tier drugs have lower copayments, while higher-tier medications will come with higher out-of-pocket costs.
For example, Tier 1 drugs might include generic medications and have the lowest copayments. Tier 2 might be preferred brand-name drugs and have slightly higher costs. Tiers 3, 4, and 5 might include specialty medications with higher price tags.
Your out-of-pocket costs can vary depending on factors like your chosen plan, the tier level of your medications, and which coverage phase you’re currently in (deductible phase or initial coverage phase, for example).
Key Factors to Consider When Before a Medicare Part D Plan
Finding a Medicare Part D plan in Delaware 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
The monthly premium is what you pay each month to keep your Medicare Part D plan active, like a subscription. While it may be tempting to choose the plan with the lowest premium, it’s crucial also to consider deductibles, copayments, and the extent of coverage.
Lower premiums often come with higher deductibles or more limited coverage, so finding a plan that balances affordable premiums with the coverage you need is important. This will help you avoid surprises later.
Annual Deductible
The annual deductible is the amount you must pay out of pocket for your prescriptions before your Medicare Part D plan starts contributing.
If you take regular medications, selecting a plan with a lower deductible can save you money over time. However, a higher deductible plan could be more economical if you rarely need prescriptions.
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 gives you prescription drug coverage, but you might wonder, "How does it fit in with my other Medicare coverage?" It's simpler than you think! Let's break it down:
Original Medicare
If you have Original Medicare, Part A covers your hospital stays, and Part B covers doctor visits and other medical services. This includes any medications your doctor administers in the office. Part D then steps in to help pay for the prescription medications you take at home. This way, you have comprehensive coverage.
Medicare Supplements
Medicare Supplements, sometimes called Medigap, help pay some of your healthcare costs that Original Medicare doesn't cover. This can be things like copays, coinsurance, and deductibles. But they don't cover everything.
For instance, Medicare Supplements don't cover prescription drugs. You'll need a stand-alone Part D plan if you want prescription coverage.
Having a Medicare Supplement plan and a Part D plan can save you a lot of money if you need a lot of medications. Although you have to pay a monthly premium for both, it can be worth it for the peace of mind. This way, you know you have good coverage for both medical and drug costs.
Medicare Advantage
Part D works differently if you have a Medicare Advantage plan, sometimes called Part C. Most Medicare Advantage plans include Part D prescription drug coverage. This means you get your medical and prescription drug coverage bundled together.
However, some Medicare Advantage plans don't include Part D, allowing you to choose a stand-alone Part D plan.
Whether you choose Original Medicare with a standalone Part D plan or a Medicare Advantage plan with drug coverage, the goal is to find what fits you best. Think about what prescriptions you take and your budget. This will help you make the best choice for your health needs.
Important Dates for Medicare Part D Enrollment
Medicare has specific enrollment periods for signing up or making changes. Here are the key ones to know:
- Initial Enrollment Period (IEP) – Starts three months before your 65th birthday and continues for seven months.
- Annual Enrollment Period (AEP) – From October 15th to December 7th, annually, for making changes to coverage.
- Medicare Advantage Open Enrollment Period – Runs annually from January 1st to March 31st for those with Medicare Advantage.
To learn more, read our Medicare Enrollment Periods Guide
.Finding Help with Medicare Part D Plan Enrollment in Delaware
Finding and comparing Delaware Medicare Part D plans alone can sometimes feel daunting. But there’s help available. Our team of experienced, licensed insurance agents is available by phone at 1-833-748-3201 (Mon-Fri 5am-6pm, Sat 6am-5pm PST).
HealthCompare agents can answer your questions and assist with plan comparisons to guide you through the process.
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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