Medicare drug coverage (Part D)
How does Medicare drug coverage work?
Medicare drug coverage (Part D) helps pay for your prescription drugs. It’s optional and offered to everyone with Medicare. Even if you don’t take prescription drugs now, consider getting Medicare drug coverage. If you decide not to get it when you’re first eligible, and you don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare drug coverage (pages 83–85). To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered. Visit Medicare.gov/plan-compare to find and compare plans in your area. You can also call your State Health
Insurance Assistance Program (SHIP) for help comparing plans. Go to pages 114–117 for the phone number of your local SHIP, or visit shiphelp.org.
There are 2 ways to get Medicare drug coverage (Part D):
1. Medicare drug plans. These plans add Medicare drug coverage (Part D) to
Original Medicare, some Medicare Cost Plans, some Medicare Advantage
Private Fee-for-Service Plans, and Medical Savings Account (MSA) Plans.
You must have Part A and/or Part B to join a separate Medicare drug plan.
2. Medicare Advantage Plans or other Medicare health plans with drug
coverage. You get your Part A, Part B, and Medicare drug coverage (Part D)
through these plans. Remember, you must have Part A and Part B to join a
Medicare Advantage Plan, and not all Medicare Advantage Plans offer drug
coverage.
In either case, you must live in the service area of the plan you want to join
and be lawfully present in the U.S.
When can I join, switch, or drop a plan?
You can join, switch, or drop a Medicare drug plan or a Medicare Advantage Plan with drug coverage during these times:
- Initial Enrollment Period. When you first become eligible for Medicare, you can join a plan. Go to page 17.
- Open Enrollment Period. From October 15 – December 7 each year, you can join, switch, or drop a plan. Your coverage will begin on January 1 (as long as the plan gets your request by December 7). Go to page 71.
- Medicare Advantage Open Enrollment Period (only if you're already in a Medicare Advantage Plan). From January 1 – March 31 each year, you can switch to a different Medicare Advantage Plan or switch to
- Original Medicare (and join a separate Medicare drug plan) once during this time. Go to page 72.
If you have to pay for Part A, and you sign up for Part B during the General
Enrollment Period (January 1 – March 31), you can also join a Medicare drug
plan when you sign up for Part B. You’ll have 2 months after signing up for Part
B to join a drug plan. Your drug coverage will start the month after the plan
gets your request to join.
