rather than going through paid insurance policies or Part D Medicare.
Those are actually one and the same. My part D is maintained by an insurance company not directly associated with the government. It is a 3rd party entity, middleman to skim money from both the people and the government. These part D insurances are also the ones to come up with the famous or infamous 'donut hole' where the patient pays back large amounts to the insurance. Not only are we paying fees to the insurance to track use or deny, they get all their money back if you go beyond the donut hole.
Which is something hardly any normal person can figure out.