Medicare Part D Prescription Drug Plans In New York
In New York, Medicare Part D covers prescription drugs not covered by Original Medicare (Parts A and B). Empire offers several Part D options to provide you with medication coverage.
Medicare Part D Plans
Medicare Part D provides coverage for prescription drugs not covered by Original Medicare. Empire offers Medicare Advantage Plans in New York that include prescription drug benefits and more. If you’re looking for a standalone Part D plan without medical coverage, Empire offers Blue Rx drug plans in New York.
Medicare Part D Plan Options
Empire offers Medicare Part D plans in New York with excellent coverage and low or no deductibles.
Our network includes thousands of pharmacies—many of which are preferred pharmacies. These pharmacies participate in Empire’s network and typically offer covered drugs at lower out-of-pocket costs than non-preferred pharmacies.
Blue Rx Standard Part D Plan
- Deductibles starting at $0
- Select list of covered drugs
- $1 to $2 copays for most generic drugs at preferred pharmacies
Blue Rx Plus Part D Plan
- $0 deductible
- Broad list of covered drugs
- $1 to $4 copays for most generic drugs at preferred pharmacies
Explore Empire's Blue Rx Part D plans or learn more about Medicare Part D coverage.
Is A Prescription Drug Plan Right For You?
Yes
- You’re enrolled in Original Medicare, Parts A or B
- You live in our plan service area
- You’d like help lowering your prescription drug costs
- You want coverage for prescriptions in the future, even if you don’t take any right now
- You have a Medicare Supplement plan or Original Medicare and want prescription drug coverage
No
- You already have a Medicare Advantage Plan that includes drug coverage
- Your union, employer, or a former employer is providing you with drug coverage
- You are not a U.S. citizen or lawfully present in the United States
Does Empire Cover Your Prescriptions?
Use our prescription search tool to find out if we cover your medications.
Medicare Part D Costs
The cost of your Medicare prescription drug coverage can depend on your income and the type of plan you purchase. People with higher incomes may pay slightly more in premiums. The Medicare Part D coverage gap is another important factor in understanding your costs. Find out more in our detailed article on Medicare Part D costs.
Need help paying for prescription drugs?
Eligible Medicare beneficiaries may qualify for prescription drug assistance through the federal program Extra Help.
Medicare Part D Glossary of Terms
Here are some common terms you may run into when comparing Medicare Part D plans.
All drugs covered by your plan are divided into pricing tiers. Generally, generic drugs fall into the lowest tiers and are the most affordable. Brand name and specialty drugs are in higher tiers that cost more.
Most plans have a formulary, which is a list of drugs the plan covers. While there are many drugs Medicare requires Part D plans to cover, you still want a plan that fits your personal prescription needs.
Some prescription drugs require your doctor to obtain prior approval and submit documentation of medical necessity before the plan will cover it.
Step therapy helps keep costs down while ensuring you get the most effective drug available. For some health conditions, the plan requires you to try a less costly, clinically effective drug before “stepping up” to a more costly one.
For safety reasons, your plan may limit the amount of medication you can receive at one time. If your prescription is in excess of safety guidelines or refilled too soon, your doctor may need to contact us for approval.
You and your doctor have the right to request exceptions set by your drug plan. You can request exceptions from step therapy and quantity limits, or request a lower cost-sharing amount for some drugs. Talk to your doctor about requesting an exception.
For safety reasons, your plan may limit the amount of medication you can receive at one time. If your prescription is in excess of safety guidelines or refilled too soon, your doctor may need to contact us for approval.
Some prescription drugs require your doctor to obtain prior approval and submit documentation of medical necessity before the plan will cover it.
All drugs covered by your plan are divided into pricing tiers. Generally, generic drugs fall into the lowest tiers and are the most affordable. Brand name and specialty drugs are in higher tiers that cost more.
Step therapy helps keep costs down while ensuring you get the most effective drug available. For some health conditions, the plan requires you to try a less costly, clinically effective drug before “stepping up” to a more costly one.
You and your doctor have the right to request exceptions set by your drug plan. You can request exceptions from step therapy and quantity limits, or request a lower cost-sharing amount for some drugs. Talk to your doctor about requesting an exception.
Medicare Part D Enrollment
Your first enrollment period for Medicare Part D is called the Initial Enrollment Period (IEP). That's a seven-month window that includes:
Three months before you turn 65
The month you turn 65
Three months after you turn 65
During this time, you can apply for Medicare Part D coverage along with Medicare Part A and Part B. To avoid penalties, it's best to enroll in Part D as soon as you're eligible, even if you are not taking prescription medications.
The Special Enrollment Period allows you to sign up for Medicare Part D outside of your initial enrollment period. To qualify, you need to meet certain criteria.
Medication Therapy Management (MTM)
The Medication Therapy Management program helps members with multiple health conditions understand and use their medications safely. The program is designed to help you and your doctor ensure the medications you take are working together to improve your health.
Frequently Asked Questions About Medicare Part D
If you are 65 or older or are already enrolled in Medicare, you are eligible for Medicare Part D.
Select a Medicare Part D plan based on your prescription drug needs.
• Make sure the plan covers the prescription drugs you use most
• Compare Medicare Part D plan costs to find one that fits your budget
• See what plans cover generic prescriptions for your medication, which may help you save
You can change to a different Medicare Part D plan during the Medicare Open Enrollment Period, which runs from October 15 to December 7 each year, unless you qualify for a special enrollment period.
More To Know About Medicare Part D
Attend A Free Medicare Event
Sign up for a free Medicare event to learn how Empire Medicare plans help cover costs that Original Medicare doesn’t. You can attend a virtual Medicare webinar. Or, if you prefer, come to a live seminar in your area where a Medicare licensed agent will be present to answer your questions.
Empire BlueCross BlueShield is a Medicare Advantage plan with a Medicare contract. Empire BlueCross BlueShield is a SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Empire BlueCross BlueShield depends on contract renewal.
Blue Rx is a PDP plan with a Medicare contract. Enrollment in Blue Rx depends on contract renewal. Administered by Empire BlueCross BlueShield and Empire BlueCross in cooperation with Excellus BlueCross BlueShield, BlueCross BlueShield of Western New York, and Blue Shield of Northeastern New York. Independent licensees of Blue Cross Blue Shield Association.