Prescription drugs are not covered by Original Medicare. If you want drug coverage you need to enroll in a stand-alone drug plan – Medicare Part D. Part D plans are run by private companies not the Federal Government, although they do get approved annually by CMS. You have the option to choose from many private insurance companies in the area/county in which you reside (this is called your “service area”). If you ever move out of your service area, then you will have to look for another prescription drug plan in your new location.
You can sign up for Medicare Part D during:
- Your IEP (Initial Enrollment Period)
When you are about to turn 65, you have a seven-month period in which you can enroll in Medicare Parts A and B. This includes three months before you turn 65, your birthday month and three months after your 65th birthday. If your birthday falls on the 1st of the month, the your seven-month period would start the month before your birth month. Let’s say your birthday is on May 1st. Then your IEP will be from January 1 to July 31. - The AEP (Annual Enrollment Period)
From October 15th to December 7th each year. You can change your prescription drug plan during this time frame. However, it will not go into effect until January 1st. - Special Enrollment Periods such as:
– Losing credible drug coverage
– Losing drug coverage from an employer or union
– You are eligible for Extra Help
Important mention: If you get Extra Help, or live in a nursing home, you may change your Part D plan once a month.
It is best to sign up for Part D early to make sure your new plan begins when it should. If you do not sign up in a timely fashion, as indicated above, you will have to pay a late enrollment penalty, which may also delay the effective date of your Part D plan. This penalty is calculated at 1% of the “national base beneficiary premium” multiplied by the number of months in which you were not covered.
Are there any requirements to be eligible for a Part D prescription drug plan?
In order to enroll in a drug plan, you are required to:
- Be enrolled in Original Medicare – Part A and/or Part B
- Reside in the service area of the plan, i.e. zip code or county
You can sign up for a Part D plan by:
- Calling Medicare at 1- 800-MEDICARE (800-633-4227); TTY: 877-486-2048;
- Call the plan of your choice or go to their online website and enroll directly
- By using Medicare’s Plan Finder tool (explained below)
If you take any medications, particularly if you take any that are expensive, it is very prudent that you use the Medicare.gov comparison tool (or have a broker do it for you) to compare the plans. The co-payments and lists of covered drugs can vary tremendously from company to company.
How Do I Pay for My Part D Prescription Drug Plan?
The monthly premium will be deducted from your Social Security benefits every month in most cases. However, you also have the option to pay the plan directly via bank draft or have them bill you instead.
