Summary: A Medicare Part D Prescription Drug plan can help round out your healthcare coverage by helping with the cost of medications. Understanding when and how you can sign up for a Medicare Part D plan is essential for ensuring you get the coverage you need while avoiding late enrollment penalties. Estimated Read Time: 8 min
How Do I Apply For Medicare Part D Prescription Drug Coverage?
Medicare Part D Prescription Drug plans help with the cost of prescription drugs for Medicare enrollees. Since Original Medicare does not cover prescriptions, Medicare Part D plans help supplement your Medicare coverage by covering some (or all) of your drug costs.
Like Medicare Advantage plans, Medicare Part D plans are provided by private insurance companies. Therefore, plan pricing and availability will vary between plan and carrier.
Before applying for a Medicare Part D drug plan, you will need to have Medicare Part A, Medicare Part B, or both. You will need your Medicare number and the start dates for your Part A and/or Part B coverage. Both pieces of information can be found on your Medicare card.
Although Medicare Part D enrollment is optional, 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. Choosing to delay Medicare drug coverage without having creditable prescription drug coverage can result in a late enrollment penalty.
When you’re ready to apply for Medicare Part D, we recommend comparing available plans in your area. Each drug plan has a formulary, or a list of drugs, that are covered under that plan. If you currently have any prescriptions, you will want to find a plan that has your medication on its formulary. Once you find a plan that meets your needs, you can apply for that plan online.
You can also sign up for a Medicare Part D drug plan by working with a licensed insurance agent. At ApplyforMedicare, a team of licensed agents can help you find and compare plans that meet your healthcare and budgeting needs.
When Can I Apply For Medicare Part D?
You can sign up for a Medicare Part D drug plan during two enrollment periods: your Initial Enrollment Period and the Annual Enrollment Period. You may join, switch, or drop a Medicare drug plan during these enrollment periods. You may also qualify for a Special Enrollment Period if you meet specific requirements.
These enrollment periods are essential to remember, as you cannot enroll in a Medicare Part D plan outside of a valid enrollment period. Remember: regardless of when you enroll, you must be enrolled in Medicare Part A and/or Medicare Part B before joining a Medicare Part D plan.
Applying for Medicare Part D During Your Initial Enrollment Period
You can sign up for a Medicare Part D drug plan during your Initial Enrollment Period. The Initial Enrollment Period is different for everyone – it is the period in which you first become eligible for Medicare. For many, this period begins three months before your 65th birthday and ends three months after.
During this seven-month period, you can sign up for any Medicare Part D plan available in your area. If you do not have creditable drug coverage, such as coverage through a job, you should consider signing up for a Medicare drug plan during this time. If you choose not to enroll in drug coverage during your Initial Enrollment Period, you may face a late enrollment penalty when you try to get drug coverage later.
If you sign up for a Medicare Part D plan during the first three months of your Initial Enrollment Period, your coverage goes into effect on the first day of the month you turn 65. If you sign up for a plan during your birthday month or the three months after, your coverage begins on the first of the following month.
Applying for Medicare Part D During the Annual Enrollment Period
During the Annual Enrollment Period, you can enroll, drop, or change your Medicare Part D Prescription Drug plan. This enrollment period occurs every year, beginning on October 15 and lasting through December 7. When you sign up during this time, your coverage starts on January 1 of the following year.
If you did not sign up for a Medicare drug plan during your Initial Enrollment Period, this is your opportunity to enroll in a plan (late enrollment penalties may apply). This period is also an opportunity to compare your existing drug plan with other available plans. You may opt to drop your current plan and enroll in another.
During the Annual Enrollment Period, you can also drop your drug plan altogether. A person may do this if they want to enroll in a Medicare Advantage plan with drug coverage instead of keeping Original Medicare and having a separate drug plan.
Signing up for Medicare Part D During a Special Enrollment Period
If you qualify for a Special Enrollment Period, you can enroll, switch, or drop a Medicare Part D plan. Special Enrollment Periods happen because of specific circumstances or events. Some events that qualify you for a Special Enrollment Period include:
- You qualify for Extra Help to pay for your prescription drugs under Medicare Part D
- You lose drug coverage that Medicare considers creditable
- 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.
New for 2024: As of January 1st, 2024, if you enroll in Medicare Part A or Medicare Part B during a Special Enrollment Period, you will have two months to join a Medicare Part D drug plan.
New for 2024: As of January 1st, 2024, if you must pay a premium for Medicare Part A and choose to sign up for Medicare Part B during the General Election Period (January 1st – March 31st), you will have two months after signing up for Medicare Part B to join a prescription drug plan.
Considerations to Make Before Signing up for a Medicare Part D Plan
Prescription costs can have a significant impact on your monthly and annual budget. A Medicare Part D drug plan can help round out your healthcare coverage and help provide the coverage you need. Before signing up for a Medicare drug plan, there are several considerations you should make.
Do I want to keep Original Medicare or get a Medicare Advantage Plan? Whether you keep Original Medicare or enroll in a Medicare Advantage (Medicare Part C) plan, you will want to ensure you get drug coverage. For those who keep Original Medicare, you must sign up for a standalone Medicare Part D plan to get drug coverage. This plan will be provided by a private insurance company, while the federal government will provide your Original Medicare benefits.
For those who choose to enroll in a Medicare Advantage plan, your plan may provide drug coverage. MAPDs, or Medicare Advantage Prescription Drug plans, are Medicare Advantage plans that provide drug coverage. When comparing MAPD plans, make sure to check the formulary to see which drugs are covered. It’s important to note that not all Medicare Advantage plans offer drug coverage. Always review plan details, costs, and benefits before signing up.
Do I have creditable drug coverage? It’s not uncommon for individuals to still be employed when they become eligible for Medicare. If you are still working during your Initial Enrollment Period and have health insurance through your employer, you may consider delaying Medicare drug coverage. For coverage to be considered creditable, it must provide benefits as good as or better than Medicare.
When in doubt, contact your benefits coordinator and ask if your coverage is creditable for Medicare. If you do not have creditable drug coverage, you will need to enroll in Medicare drug coverage (either a standalone Part D plan or a Medicare Advantage plan with drug coverage) when you first become eligible for Medicare. Failing to do so could result in a late enrollment penalty.
What medications am I currently taking? What medications might I need in the future? Before you begin comparing Medicare drug plans, write down all medications you’re currently taking. You may also want to consider any medications you think you will need in the future. Each Medicare drug plan will have a list of drugs it covers (called a formulary). Having your list of medications readily available will make comparing Medicare Part D drug plan formularies easier.
What if I can’t afford Medicare Part D? Medicare Part D plans have out-of-pocket costs you should factor into your budget. If you have limited income or resources and don’t think you can afford drug coverage, you may qualify for Extra Help. This program helps pay the out-of-pocket costs for Medicare Part D. You can apply for Extra Help through the Social Security Administration.
Learn More About Medicare Part D
Medicare prescription drug plans help round out your healthcare coverage by reducing the out-of-pocket costs of medications. Whether you are new to Medicare or are simply looking for more information on Medicare Part D, we’re here to help. We have a team of licensed agents that can help answer your questions and help you better understand how to get Medicare drug coverage. Give us a call at the number above to speak directly with an agent.
How to Get Prescription Drug Coverage, Medicare. Accessed September 2023
Medicare & You 2024, Medicare. Accessed September 2023