Types of UnitedHealthcare Plans
Medicare Prescription Drug (Part D) Plans
Get help covering the cost of your prescription drugs.
A Medicare Prescription Drug (Part D) plan can help cover the costs of your medication.
What do Medicare prescription drug plans cover?
All Medicare Prescription Drug plans cover the types of drugs most often prescribed for people enrolled in Medicare. This is decided by the U.S. government. But it's up to each plan which specific brand name and generic drugs they will cover within those types. You can find this information by viewing a plan's drug list.
What should I know about a plan's drug list?
A drug list—sometimes called a formulary—is a list of drugs covered by a plan.
- A drug list can change from year to year.
Part D plans may add or remove drugs from their drug list each year. Changes may also be made during the year, for example if a drug is taken off the market. Your plan will let you know if a change affects a drug you are taking.
- Many Part D plans have a tiered drug list where drugs are divided into groups based on cost.
In general, drugs on low tiers cost you less than drugs on high tiers. Plans may charge a deductible for certain drug tiers and not for others, or the deductible amount may be different depending on the tier.
Drug list tiers:
Tier 1
$
(Lowest cost)
Tier 2
$$
Tier 3
$$$
Tier 4
$$$$
Tier 5
$$$$$
(Highest cost)
What does it mean if my prescription drug has a requirement or limitation?
There are rules for some prescription drugs that limit how and when a plan will cover them. These are called requirements or limitations. If you don't follow these rules or don't get permission from the plan saying you don't have to (called an exception), you may have to pay the full cost of the drug out of your own pocket. You can find out if a drug has any requirements or limitations by looking for the following abbreviations next to the drug names in a plan's drug list:
PA – Prior Authorization
The plan needs you or your doctor to get prior authorization before they will agree to pay for this drug. This means the plan needs more information from your doctor about how the drug is going to be used.
QL – Quantity Limits
The plan will cover only a certain amount of this drug or type of drug for one copay or over a certain number of days. For example, the plan may only let you have 30 pills per month of a certain drug.
ST – Step Therapy
There may be lower-cost drugs that work just as well for a medical condition such as this one. The plan might want you to try one or more of these other drugs before it will cover the drug that costs more.
B/D – Medicare Part B or Medicare Part D Coverage Determination
Depending on how this drug is used, it may be covered by either Medicare Part B (doctor and outpatient health care) or Medicare Part D (prescription drugs). Your doctor might need to give the plan more information about how this drug will be used to make sure it's being covered by the right part of Medicare.
Covered Insulin Costs
For Chronic Special Needs Plans in 2025, you will pay a maximum of $25 for each 1-month supply of Part D covered insulin drug until the Catastrophic Coverage stage, when you will pay nothing.
For all other plans in 2025, you will pay a maximum of $35 for each 1-month supply of Part D covered insulin drug until the Catastrophic Coverage stage, when you will pay nothing.
How can I get the best value from my Medicare Prescription Drug plan?
Here are some suggestions to help you make sure your Medicare Prescription Drug plans is a good fit for your health care and budget needs.
- Know the drug list:
Make sure your medication you take is on a plan's drug list. If it's not, check with your provider to see if there's one on the drug list you can switch to.
- Consider generics:
Ask your provider about generic or low‑cost options for drugs in high tiers or that are expensive.
- Ask if your plan participates in the Part D Senior Savings Model for Insulin1.
- Show your member ID card:
Be sure to show your member ID card when you fill prescriptions. That way, you'll be sure to get any cost saving available to plan members.
- Use the mail order pharmacy:
You may be able to save money when you get at least a 3-month supply of your medication delivered to your home.
- Use a preferred network pharmacy:
Many plans offer cost savings if you fill your prescriptions at a pharmacy within the plan's preferred network.
1You will pay a maximum of $35 for a 1-month supply of insulin during the deductible, initial coverage and coverage gap or "donut hole" stages of your benefit. You will pay a maximum of $35 for a 1-month supply of insulin during the deductible, initial coverage and coverage gap or "donut hole" stages of your benefit. You will pay 5% of the cost of your insulin in the catastrophic coverage stage. Your costs may be less if you receive Extra Help from Medicare.
Read Next:
Enrollment Basics
See UnitedHealthcare Plans Available in Your Area
Explore the Medicare Advantage, Medicare Prescription Drug and Medicare Supplement plans that may be available in your area.
Still have questions?
Give Us a Call
Meet with a Licensed Insurance Agent/Producer
View Important Disclosures Below
UnitedHealthcare Insurance Company pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. AARP does not employ or endorse agents, brokers or producers.
AARP® encourages you to consider your needs when selecting products and does not make product recommendations for individuals.
Please note that each insurer has sole financial responsibility for its products.
AARP® Medicare Supplement Insurance Plans
AARP endorses the AARP Medicare Supplement Insurance Plans, insured by UnitedHealthcare Insurance Company.
Insured by UnitedHealthcare Insurance Company, 185 Asylum Street, Hartford, CT 06103 (available in all states/territories except ND, NY) or UnitedHealthcare Insurance Company of America, 1600 McConnor Parkway, Floor 2, Schaumburg, IL 60173 (available in AR, AZ, IL, IN, MS, NC, ND, NJ, OH, PA, SC, TN) or UnitedHealthcare Insurance Company of New York, 2950 Expressway Drive South, Suite 240, Islandia, NY 11749 (for NY residents). Policy Form No. GRP 79171 GPS-1 (G-36000-4).
In some states, plans may be available to persons under age 65 who are eligible for Medicare by reason of disability or End-Stage Renal Disease.
Not connected with or endorsed by the U.S. Government or the federal Medicare program.
This is a solicitation of insurance. A licensed insurance agent/producer may contact you.
You must be an AARP member to enroll in an AARP Medicare Supplement Plan.
THESE PLANS HAVE ELIGIBILITY REQUIREMENTS, EXCLUSIONS AND LIMITATIONS. FOR COSTS AND COMPLETE DETAILS (INCLUDING OUTLINES OF COVERAGE), CALL A LICENSED INSURANCE AGENT/PRODUCER AT THE TOLL-FREE NUMBER ABOVE.
Medicare Advantage plans and Medicare Prescription Drug plans
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan's contract renewal with Medicare. You do not need to be an AARP member to enroll in a Medicare Advantage plan or Medicare Prescription Drug plan.
This information is not a complete description of benefits. Contact the plan for more information.
WB26626ST