Medicare Part D is coverage for prescription drugs. It pairs with Original Medicare, Parts A and B, to provide comprehensive health care coverage. Part D has plans that list which medications they cover and payment plans for other prescriptions.
Medicare Advantage Plans may have coverage for prescription drugs. However, all private plans do not have drug coverage, so review the details of each policy before enrolling. For example, Medical Savings Account plans and certain Private Fee-for-Services plans do not have drug coverage. If you have a Part C plan without drug coverage, you can enroll in a separate drug plan.
Likewise, you may be able to sign up for a Medicare drug plan even if you have employer-based health insurance. If you meet the Medicare eligibility requirements but opt to keep your employer-based insurance without drug coverage, you can still enroll in a Medicare drug plan.
Some tips when selecting drug coverage:
- Check out the formulary list (covered drugs) of plans before enrolling to confirm coverage of your prescriptions.
- Look for drug plans without a coverage gap if you want extra protection from high drug costs.
- Consider taking generic prescriptions with lower costs if your name-brand drug is high on the plan’s tiers.
You have a seven-month initial enrollment period. You are eligible for enrollment in Part C or D starting three months before your 65th birthday.
Your initial enrollment period closes at the end of the third month after your birthday month. For instance, if you were born in June, your initial enrollment period is March 1st to September 30th.
If you miss these periods or need to change your prescription drug coverage, you can wait for the open enrollment period. During open enrollment from October 15th to December 7th, you can:
- Change from a Medicare Advantage Plan that does not offer drug coverage to one that does.
- Change from a Medicare Advantage Plan that does offer drug coverage to one that does not.
- Enroll in a Medicare drug plan.
- Switch between Medicare drug plans.
- Drop your Medicare drug plan altogether.
You can also sign up for drug coverage through a Medicare Advantage Plan. Open enrollment for Part C plans is from January 1st to March 31st each year.
If you are an SSI applicant, you may be eligible for the Extra Help program. The Extra Help program helps cover some health care expenses, including prescription drug costs. The Extra Help program can cover costs like premiums, deductibles, and coinsurance.