are options, so together, we can find the plan that best meets your unique health
care needs. Read on to learn what you need to know about Medicare Part D.
Medicare Part D is prescription drug insurance, which covers the cost of both brand-name and generic prescription drugs.
Medicare prescription drug coverage is optional. However, Part D plans are available to everyone who has Medicare.
To sign up for Part D, you must:
As with any other Medicare plan, you can only enroll in Medicare Part D during specific times of the year. There are also specified date ranges during which you can change or drop your coverage.
Here are the deadlines you need to know:
When you first become eligible for Medicare, you begin your initial enrollment period, during which you can sign up for Part D. If you sign up for prescription drug coverage outside of your IEP, you’ll typically pay a late penalty, which will be added to your monthly premium.
Each year, the Medicare open enrollment period occurs between these dates. During this time, you can enroll in a Part D plan, change your Part D plan, or drop your coverage entirely. However, dropping coverage may incur a penalty if you do not have any other form of prescription drug coverage.
This is the General Medicare Enrollment Period. During this time, you can change or drop your MA plan with Part D coverage. If you are enrolled in Original Medicare, you cannot join a Part D plan during this period.
If you have Medicare Part A and signed up for Part B for the first time during the General Enrollment Period, you can sign up for a Part D plan during this time. You can also choose to enroll in a Part C plan that includes Medicare prescription drug coverage.
To get prescription drug coverage under Medicare, you must sign up for a Medicare plan that offers it. There are two ways to do this:
Remember that not all Medicare prescription drug plans pay for the same prescriptions. Because plans can vary the list of drugs they cover as well as the tiers they place those drugs into, it’s always best to speak with a knowledgeable, licensed advisor regarding your needs.
That said, all Part D plans must provide, at a minimum, the standard level of coverage set by Medicare.
What you pay for Medicare prescription drug coverage varies according to your plan. If you’re enrolled in Original Medicare, you’ll pay a monthly premium for Part D in addition to the premium you pay for Part B. If you’re enrolled in a Medicare Advantage plan (Part C) that includes prescription drug coverage, your monthly premium will typically reflect a specific amount for drug coverage.
Your modified adjusted gross income may also affect the amount you pay for your monthly premium, but only if your MAGI is above a certain amount. Social Security will let you know whether your income requires you to pay a Part D income-related monthly adjustment amount (Part D IRMAA).
As mentioned, if you do not sign up for a Part D plan when you first become eligible for Medicare — even if you’re not taking any prescription drugs at that point — you’ll pay a penalty. However, you can avoid that penalty if you already have creditable drug coverage from another health insurance plan (from your employer, for example).
If you don’t have creditable drug coverage (coverage that’s equal to or greater than the standard level of coverage set by Medicare) it’s a good idea to enroll in a low-cost Part D plan when you first become eligible, just to avoid the penalty. If you need to change plans later, you can do so during the Fall Open Enrollment Period.
For more information on all things Medicare Part D, check out the Centers for Medicare & Medicaid Services’ Guide to Medicare Prescription Drug Coverage.
When you have questions, our licensed advisors have answers, so give us a call at 651.358.2990