What is Medicare Part D?
Medicare Part D is the federal government’s prescription drug program that covers both brand-name and generic prescription drugs at participating pharmacies in your area. The coverage is available to all people eligible for Medicare, regardless of income and resources, health status, or current prescription expenses.
Important: The cost of coverage may increase the longer you wait to enroll.
How does Medicare prescription drug coverage work?
Medicare Part D works in tandem with Medicare Parts A and B. Individuals entitled to Part A or enrolled in Part B can sign up for Part D to receive help paying for prescription drugs. Like other insurance, if you join, you will pay a monthly premium, which varies by plan, and (for most plans) a yearly deductible. You will also pay a part of the cost of your prescriptions, including a co-payment or coinsurance. Costs will vary depending on which drug plan you choose. Some plans may offer more coverage and additional drugs for a higher monthly premium. Plans also vary in terms of the co-pays, prescription drugs that are covered (this is called the “plan formulary”) and the pharmacies that may be used.
If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible. Individuals enrolled in both Medicare and Medicaid (“Dual Eligibles”) who have not already selected a Part D plan will be automatically enrolled in Medicare Part D by their state agency.
If I am on Medicare do I have to enroll in Part D?
Medicare Part D is an optional plan. No one is required to enroll, but if you are eligible and delay enrolling, you risk paying a penalty in terms of increased insurance premiums when and if you enroll at a later date.
How do I get more information and enroll?
Unless you are enrolling in Medicare for the first time, Part D enrollments are limited to specific times of year or following specific events (changes in coverage).