Learn About Medicare Part D
What is Medicare part D?Have you found yourself wondering, “What is Medicare Part D?” Medicare Part D is an optional part of Medicare that can be added onto Medicare Part A and Part B plans for additional benefits. Part D primarily provides benefits for prescription drugs, which must otherwise be paid out of pocket.
While Medicare Part D is optional, you will pay a late enrollment penalty if you do not choose to enroll when you initially qualify for Medicare. If you opt out of Part D when enrolling in the Medicare program, you will pay a higher cost for plans later.
What do Medicare Part D drug plans cover?
Each Medicare drug plan will include its own list of covered prescription drugs. These prescriptions may be brand-name or generic prescription drugs. If one of your prescriptions is not covered by the plan, you will likely get coverage for a similar prescription.
However, if your doctor believes that the other drug will not be effective, you can ask Medicare for an exception.
Your provider will need a medical statement to request the exception, but you may very likely get coverage for the prescription you need.
Medicare Part D CostMedicare Part D plans can only be obtained by paying a premium. However, the cost of your plan may vary based on:
- The prescriptions that you use.
- The drug plan that you select.
- The pharmacy you go to (whether or not it's in your plan’s network.)
- Whether or not you receive extra help paying for your Medicare Part D.
- Late enrollment, for which you are penalized.
- Annual deductibles.
- Coinsurance or copayments.
- Expenses associated with coverage gaps.
How to Enroll in Medicare D PlansYou can enroll in Medicare Part D plans in several ways, including:
- By filling out a paper enrollment form
- By phone
Before enrolling in a Part D plan, make sure you review how Part D works with any other form of health insurance you have. If you currently have Medicaid, TRICARE, or an insurance plan through an employer or union, you may already have prescription drug coverage. Therefore, it can be beneficial to contact any other form of insurance you have to determine whether or not you need Medicare Part D.
Medicare Part D Drug Plans and Medicare Part CYou do not need a Medicare drug plan if you are currently enrolled in Medicare Part C. Part C plans will generally include the benefits of Part A, B, and D plans as well as additional benefits.
Medicare Part D cannot be added onto a Medicare Part C plan unless your plan does not include prescription drug coverage. If you have a Part C plan that does and you enroll in Medicare Part D, then you will automatically be removed from your Part C plan. Should this happen, you will automatically be enrolled back into Medicare Part A and Part B plans.
While rare, it is possible that your Medicare Part C plan does not include prescription drug coverage. If this is the case, you will be allowed to enroll in Part D. However, you should always review your plan details or contact your provider before enrolling in Medicare Part D.