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Prescription Drug Plans

Georgia Part D Medicare Plans & Prescription Drug Coverage

There are two ways to get Medicare Part D prescription drug coverage:
  1. Medicare Prescription Drug Plans. These plans (sometimes called “PDPs”) add drug coverage to Original Medicare (Parts A and B) and some Medicare Advantage Plans (Part C).
  2. Medicare Advantage Plans that offer prescription drug coverage. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You get all of your Part A and Part B coverage, including prescription drug coverage (Part D), through these plans.

Part D Plans may have the following coverage rules:
  • Prior authorization - You and/or your doctor must contact the plan before you can fill certain prescriptions.
  • Quantity limits - Limits how many pills you can get at a time.
  • Step therapy - You must try one or more similar, lower cost drugs before the plan will cover the drug your doctor prescribed.

If your doctor believes that one of these coverage rules should be waived, you can ask for an exception.

According to GeorgiaCares:

To join a Medicare Prescription Drug Plan, you must have Medicare Part A and/or B. To join a Medicare Advantage Plan, you must have Parts A and B. You must also live in the service area of the Medicare drug plan you want to join.

Once you choose a Medicare drug plan, you may be able to join by completing a paper application, calling the plan, enrolling online or contacting GeorgiaCares (1.866.552.4464). Medicare drug plans are not allowed to call you to enroll you in a plan.

As with other Medicare-related coverages, GeorgiaCares spends a lot of time talking about how you can change the Part D plan you use. Here are some details:

You can join, switch or drop a Medicare drug plan at these times:
  1. Initial Enrollment Period - When you first become eligible for Medicare. The 3 months before you turn age 65 to 3 months after the month you turn age 65.
  2. Annual Enrollment Period - Between October 15 and December 7 each year. Coverage will begin January 1.
  3. Special Enrollment Period - 1) If you move out of your plan’s service area; 2) if you have both Medicare and Medicaid; 3) if you qualify for low income subsidy (“extra help”); or 4) if you live in an institution (e.g., nursing home). Other situations may qualify you for a special enrollment period.

Often times, you can switch to a new Medicare drug plan simply by joining another drug plan. You do not need to cancel your old Medicare drug plan or send them anything. Your old Medicare drug plan coverage will end when your new drug plan begins. You should get a welcome packet from your new drug plan stating when your coverage begins.

The list below contains the highest rated Medicare Part D prescription drug plans in the state of Georgia. It is for informational purposes only and some listings may be inaccurate or missing. The list was provided by the Centers for Medicare and Medicaid Services (CMS), but due to the variance in plans based on county, city, and region, some options may not be available in your location.