Medicare Part D

What is Medicare Part D?

When you sign up for Original Medicare (Part A and B), you do not automatically get prescription drug coverage, and it is optional.  Medicare Part D is the plan you can purchase to help pay for many of your prescription drugs outside of the doctors office.  Depending on the level of prescription drugs you take, a Medicare Part D plan could come in handy.

Who’s Eligible for Medicare Part D?

Anyone with Medicare is eligible to get prescription drug coverage.  You must have Medicare Part A and/or B to enroll in a Medicare Prescription Drug Plan.  While it is optional, keep in mind that if you do not sign up when first eligible, you may pay penalty fees if you’d like to sign up in the future.  These will most likely apply unless you have creditable coverage through another plan, or you get Extra Help.

If will need to have both Medicare Part A and B if you would like to enroll in a Medicare Advantage Prescription Drug Plan.

Note: If you have a Medicare Advantage Plan that includes prescription drug coverage, and then sign up for a Medicare Prescription Drug Plan (Part D), the Medicare Advantage Plan (Part C) will disenroll you.

Types of Medicare Part D

You have two options for obtaining prescription drug coverage:

  1. Medicare prescription drug plan (Part D) – These plans can be purchased as an add-on to your Original Medicare.
  2. Medicare Advantage Plan (Part C) – You also have the option of purchasing a Medicare Advantage Plan that manages your Original Medicare, and in some cases will also include prescription drug coverage.  You must have Medicare Part A and B, and also be sure that the drug coverage you are purchasing covers any existing medications you know you’ll need.

Note:  You may have drug coverage through other insurance such as an employer or a supplemental insurance plan.  If that’s the case you’ll need to ensure you know how Medicare Part D works with these other plans.

When to Enroll in Medicare Part D?

If you plan to sign up for Medicare Part D, the best time is during the Initial Enrollment Period (IEP) in which you are eligible to enroll in Original Medicare so that you avoid the payment of any late fees for signing up late.  Remember this IEP last for seven months, beginning three months before the month you turn 65, includes the month of your birthday, and then remains open for the three months after your birthday month.

You can also enroll in Medicare Part D each year during enrollment periods for both Part D and Part C.

From October 15 – December 7 there is Open Enrollment for Medicare Advantage and Medicare Prescription drug coverage.  During this time period you can make changes to current plans you are enrolled in, join a Medicare Prescription Drug Plan, or drop your plan if for some reason you no longer need drug coverage.

There is also a Medicare Advantage Disenrollment Period that runs from January 1 – February 14.  During this time you can disenroll in your Medicare Advantage Plan, enroll in Original Medicare, and at this time you will also have the option to join a Medicare Prescription Drug Plan

What are the costs of Medicare Part D?

Whether you get your prescription drug coverage through a Medicare Prescription Drug Plan, or through a Medicare Advantage drug plan, you’ll likely have the following costs:

Monthly Premium – This is the monthly cost you will continue to pay as long as you continue with a Medicare or Medicare Advantage drug plan.

Annual Deductible – As with most health plans before you were eligible for Medicare, there is an annual deductible associated with most of these plans that you will need to hit before the plan starts paying.

Coinsurance/Copayment – This is the share of the cost you pay depending on your plan every time you purchase a prescription.  These cost can vary depending on the type of drug you are purchasing.


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