Part D / Drug Plans

Medicare Part D coverage is also known as the Medicare Prescription Drug Benefit. Private insurance companies offer Part D plans, but they aren’t standardized like Medigap plans.

The various letters assigned to Medicare plans can be confusing, but this one is easy: D for drugs!

Enrollment in Medicare Part A and B is required to be eligible for a Part D plan.

Medicare Part D plans are optional,  but there is a penalty for not enrolling when eligible for coverage. The “Late Enrollment Penalty” applies when someone is eligible (age 65 or older) and does not have creditable prescription drug coverage.  Most group plans have creditable prescription drug coverage,  but high-deductible health plans (HDHPs) do not. Most people aren’t aware of this and sometimes learn the hard way.

It is recommended that people enroll in a Part D plan whether or not they take any prescription drugs. It’s important to have this coverage in place just in case the need arises.  After all, this is the purpose of insurance!

We help our clients select the best, most cost effective plan based on their prescription drugs. We use the Medicare Plan Finder to prepare customized plan comparison reports.

Most Medicare Advantage plans (Part C) include a prescription drug plan also, so there is no need to shop for one separately.

Medicare Supplement Plans do not include a prescription drug plan.

We ask our clients to give us a list of their prescription drugs, including the dosage and frequency of use.

Unlike selecting a Medicare supplement plan, it is not as critical to select the best Part D plan for the long term – only for the current year.

Medicare beneficiaries can change their prescription drug plan every year during open enrollment, if necessary or desired. It is important to check plans every year even if there are no significant changes to the plan design or premium. Carriers can change their drug formulary, their plan benefits, and their premiums each year, so that’s why it’s important to review coverage and compare options annually.