What Is Medicare Part D – Part D is an important addition to your health insurance coverage. It offers prescription drug coverage only, which is not included in Parts A and B of Original Medicare. Without a Part D plan, you will not have any insurance benefits when you fill your prescriptions at the pharmacy.
This article will discuss the two ways you can get prescription drug coverage, when to enroll, and also when to have your plan reviewed. Not taking prescriptions? Don’t skip this information! We’ll talk a little about why you need to enroll in Part D, regardless of if you’re taking medications or not.
Two Ways to Enroll in Part D
There are two ways you can choose to get your Part D benefits: either as a stand-alone plan or as part of a Medicare Advantage plan.
Stand-Alone Plan
If you choose to enroll in a Medicare supplement and keep your Original Medicare, you’ll need to enroll in a separate Part D plan. You’ll pay a separate premium for Part D, and your plan may not be with the same insurance company as your supplement plan is with.
Medicare Advantage Prescription Drug Plan
Many Medicare Advantage (Part C) plans include prescription drug coverage. If they do, we refer to these as MAPD plans. Instead of enrolling in a separate policy, the drug coverage is included in MAPD options. It will still work like traditional Part D plans, but the coverage is bundled into one policy.
If you have a Medicare Advantage plan that does not include drug coverage, you may or may not be able to get a separate policy. If you have a PPO, HMO, HMO-POS, or SNP plan, you cannot enroll in a separate Part D plan, even if drug coverage is not included in your plan. However, if you have a PFFS or MSA plan, you may apply for Part D along with it.
Enrolling in a stand-alone Part D plan if you are already enrolled in an MAPD plan will automatically disenroll you from your Part C plan.
When to Enroll in Part D
You should enroll in Part D either when you turn 65 or when you lose creditable coverage, whichever happens last.
You can enroll in Part D when you are first eligible to enroll in Medicare, which is around your 65th birthday. You can begin choosing plans three months prior to your birthday and have until three months after your birthday to enroll without penalties. To avoid a lapse in coverage, you should try to enroll before your birthday month.
If you have creditable coverage, you can delay Part D enrollment without a penalty. Typically, this occurs when someone wants to continue working past age 65, and they have a group plan through their employer. As long as the plan is creditable, you can wait to enroll in Part D (and other parts of Medicare) until you lose that coverage.
Even if you are not taking prescription medications, it is important to enroll in Part D as soon as you are eligible or no longer have other coverage. If you don’t, you’ll pay a penalty in the future. That penalty sticks with you for life, so it could cost you thousands of dollars if it happens to you.
In addition, you can’t enroll in Part D year-round. If you decide you need to enroll outside of the enrollment window, you may have to wait several months to get a plan.
Part D and the Annual Enrollment Period
Whether you enroll in a stand-alone Part D plan or have one as part of your Medicare Advantage plan, you need to have it reviewed every year during the Annual Enrollment Period or AEP. AEP runs from October 15 to December 7. Changes during that time will go into effect on January 1.
The reason for this is that Part D plans can change each year. You might see a change in premiums, cost-sharing amounts, or the medications included in the plan. Plus, your prescriptions might have changed as well, so you should find out how that change impacts your coverage.
Reviewing your Part D plan does not take long and is usually done over the phone. Your insurance agent will update your medication list and then find the plan that offers the least out-of-pocket costs. They’ll also make sure you’re using the pharmacy that gives you the best rates.
Ready to shop for Medicare Part D? Our Medicare experts can help you find the plan that makes the most sense for you. We’ll discuss your current medications and any changes that you think you might have over the year. Then, we’ll look at multiple insurance carriers to find the one that gets you the most competitive rates. There is no charge to work with us, so don’t hesitate to reach out!
