Medicare Part D helps with the cost of prescription drugs for beneficiaries. If you enroll in Original Medicare (Part A and Part B), it is essential to consider Medicare Part D enrollment. This component helps cover drug costs, and enrolling prevents a penalty in the future. Medicare Part D enrollment is a simple process that you can complete online.
HOW DO I APPLY FOR MEDICARE PART D PRESCRIPTION DRUG COVERAGE?
Unlike Medicare Part A and Medicare Part B, you do not get Medicare Part D prescription drug coverage through the government. Instead, these plans are available through private insurance companies. Thus, the application process does not involve the Social Security Administration.
However, it is necessary to enroll in Original Medicare before beginning the Medicare Part D enrollment process. Although Medicare Part D enrollment is voluntary, it is wise to consider your current and future health needs before delaying or denying coverage.
Often, it makes sense to enroll in Medicare Part D when you first become eligible, even if you do not take any prescription medications. Also, if you delay Medicare Part D, you can face a penalty when you enroll.
Before enrolling in a Medicare Part D plan, you should research the available plans in your area. It is vital to ensure the formulary for the plan of your choice includes any prescriptions you currently take or expect to take in the future, the dosages, and whether they are the generic or brand-name versions. You can find and sign up for your policy of choice online.
WHEN TO APPLY FOR MEDICARE PART D
Medicare Part D enrollment can happen during your Initial Enrollment Period or the Annual Enrollment Period. Your Initial Enrollment Period is your first opportunity to sign up for Original Medicare. Once you enroll in either Part of Original Medicare, you will be eligible to enroll in a Medicare Part D plan.
The Initial Enrollment Period is a one-time enrollment opportunity for many Medicare beneficiaries. This enrollment period begins three months before your 65th birthday, lasting the month of your birthday and ending three months following your birth month. Thus, you initially have seven months to enroll in a Medicare Part D plan.
The Annual Enrollment Period is your next opportunity to add Medicare Part D prescription drug coverage. This enrollment period begins every October 15 and lasts through December 7. When you sign up during this time, your coverage starts on January 1 of the following year.
Additionally, suppose you enroll in Medicare Part A and Medicare Part B during the General Enrollment Period. In that case, you will be eligible for Medicare Part D enrollment at this time as well.
Yet, if you qualify for a Special Enrollment Period, you can make changes outside these windows. Special Enrollment Period eligibility happens when certain circumstances arise, such as the following:
- You newly qualify for Extra Help to pay for your prescription drugs under Medicare Part D
- You lose drug coverage that Medicare considers creditable for Part D
- You no longer reside in your plan’s service area
If any of these situations arise, it is vital to act fast. Special Enrollment Periods are only valid for a specific time before you forfeit the enrollment benefits.
APPLY FOR MEDICARE PART D EXTRA HELP
If you have trouble paying for Medicare Part D, Extra Help is available. Extra Help is a program for Medicare-eligible people who struggle to pay for prescription drugs due to insufficient income and resources. Different levels of this assistance are available to help pay for premiums, deductibles, and coinsurance.
If you receive Supplemental Security Income (SSI), get assistance paying for Medicare through a Medicare Savings Plan (MSP), or are dual-eligible for Medicare and Medicaid, you automatically qualify for Extra Help. You can show your Medicare Part D plan documents from Medicaid to prove eligibility.
To otherwise prove eligibility, complete the application for Extra Help with Medicare Part D online at SSA.gov. If you qualify, you can send your plan a copy of your Notice of Award from Social Security.
Applying for Extra Help is not the same as applying for Medicare Part D coverage. You will still need to select a plan and enroll during a valid enrollment period to receive benefits.