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Medicare part D: Prescription drug coverage
How Medicare Part D Plan works



What does it cover?

Original Medicare (Parts A and B) does not include prescription drug coverage.  Medicare part D plans cover certain prescription drugs.  When comparing Medicare part C coverage, check each plan's formulary ( drug list) to make sure  your drugs are included.  

  • The federal government sets guidelines for they types of drugs Medicare Part D plans must cover.

  • Each Medicare part D plan decides which specific drugs it will cover and what members will pay.

  • Medicare part D plans are available to those eligible for Medicare

  • If you choose to enroll in a Part D plan, you can only do so through a private insurance company that is contracted with medicare.

When to enroll in Medicare Part D plan

Your initial Enrollment Period (IEP) is 7 months along.  It includes your birthday month, plus the 3 months before and the 3 months after your birthday month.  Your IEP begins and ends one month earlier if your birthday is on the 1st of the month.

If you have creditable drug coverage through your employer or other insurance, you don't' need to enroll in a Part D plan right away.  Creditable drug coverage is coverage at least as good as you could get through medicare part D. You have a two-month Special election Period to enroll in a medicare Part K plan after losing other coverage. You could be charged a penalty if  you go without creditable drug coverage over 63 days.

There is a Medicare Part D Late Enrollment Penalty

Although you are not required to enroll in Part D, there is a penalty of 1% of the average monthly premium for each month you delay enrollment. This must be paid monthly as long as you are enrolled in Part D.

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