What you need to know about Medicare Part D.

Medicare Part D

Medicare prescription drug coverage (Medicare Part D) is an optional benefit offered to everyone who has Medicare. This program provides prescription drugs through private insurance companies that have contracts with the federal government. Unlike the original Medicare program, Medicare Part D is not provided directly by the government.

You can get prescription drug coverage through:

Medicare Part D Drug Plans (PDPs) add drug coverage to original Medicare, some Medicare Cost Plans, Medicare Private Fee-for-Service Plans and Medicare Medical Savings Accounts.
Medicare Advantage Plans (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage. Medicare Advantage Plans with prescription drug coverage are sometimes called “MA-PDs.” You must have Part A and Part B to join a Medicare Advantage Plan

Click here for more information about Medicare Part D

Click here to find a Medicare drug plan that’s right for you

Sources: Centers for Medicare and Medicare Service 2019, Medicare Interactive 2019

How to sign up for Medicare Part D

Once you choose a Medicare drug plan, there are a few different ways you can sign up: for prescription drug coverage You can:

Enroll on the Medicare Plan Finder or on the plan's website at Medicare.gov
Complete a paper enrollment form from the local Social Security Office
Call the plan.
Call us at 1-800-MEDICARE (1-800-633-4227).

When you join a Medicare drug plan, be sure to have handy your Medicare Number and the date your Part A and/or Part B coverage started.

If you decide not to get Medicare Part D when you are first eligible, you will pay a late enrollment penalty unless:

You have another creditable prescription drug coverage plan
You qualify for Medicare's Extra help program (which helps qualifying patients pay prescription costs, premiums, deductibles, and coinsurance of Medicare prescription drug coverage

Click here for more information on Medicare's Extra Help Program

Benefits of Medicare Part D

Medicare Part D works with the following types of programs

Employer or union health coverage
COBRA
Medicare Supplement Insurance (Medigap) policy prescription drug coverage (this not considered a creditable drug plan). In the event that you sign up for Medicare Part D, you must remove the prescription drug coverage under your Medigap policy and adjust your premiums
Medicaid
If you have full coverage from Medicaid and live in a nursing home, you pay nothing for covered prescription drugs.
If you have full coverage from Medicaid and live in an assisted living or adult living facility, or a residential home, you'll pay a small co-payment for each drug.
If you don't join a drug plan, Medicare will enroll you in one to make sure you don't miss a day of coverage. If you decide you want another plan, you can switch to another plan at any time.
Supplemental Security Income Benefits:
If you get benefits or help from your state Medicaid program paying your Medicare premiums, you need to join a Medicare Prescription Drug Plan for Medicare to cover your drugs. You automatically qualify for Extra Help with your prescription drug costs. If you don't join a plan, Medicare will enroll you in one to make sure you don't miss a day of coverage.
State Pharmaceutical Assistance Program
Each state decides how its State Pharmaceutical Assistance Program (SPAP) works with Medicare prescription drug coverage. Some states give extra coverage when you join a Medicare Prescription Drug Plan.
Long-term Care
Long-term care pharmacies contract with Medicare Prescription Drug Plans to provide drug coverage to their residents. If you're entering, living in, or leaving a nursing home, you'll have the opportunity to choose or switch your Medicare drug plan
HUD housing Assistance
If you qualify for Extra Help, you won't lose your housing assistance. However, your housing assistance may be reduced as your prescription drug spending decreases. The value of the Extra Help paying your drug costs will make up for any decrease in your housing assistance.
Food Stamps
If you qualify for the Extra Help program, your food stamps amount may decrease.
Health Insurance Marketplace:
Online platform the offers insurance plans to individuals, families and small business. Each state has their own marketplace and prices varies depending on plan coverage

Creditable Medicare Insurances

A group health plan's prescription drug coverage is considered creditable if it pays at least the Medicare standard for prescription drug coverage. People that currently have this type of insurance when they become eligible for Medicare can keep this coverage without paying a penalty for not enrolling in Medicare Part D.

Most Common Types of Creditable Insurances

Federal Employee Health benefits Program
Veteran Benefits
TRICARE (military health benefits)
Civilian Health and Medical Program of the Department of Veterans Affairs
Indian Health Services