Medicare Part D

How to Get Prescription Drug Coverage?

To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. Here are the two ways to get drug coverage:

  • Medicare Part D: Adds drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) Plans, and Medicare Medical Savings Account (MSA) Plans.
  • Medicare Advantage Plan (Part C): You get all of your Medicare Part A (Hospital Insurance)and Medicare Part B (Medical Insurance) coverage, and prescription drug coverage (Part D), through these plans. 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.

To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare.

How to Join a Drug Plan:

  • Enroll on the Medicare Plan Finder or on the plan’s website.
  • Complete a paper enrollment form.
  • Call the plan.
  • Call 1-800-MEDICARE (1-800-633-4227).
  • When you join a Medicare drug plan, you’ll give your Medicare number and the date your Part A and/or Part B coverage started. This information is on your Medicare card.

Drug Costs Depend On

  • The drugs you use.
  • The plan you choose.
  • Whether you go to a pharmacy in your plan’s network.
  • Whether the drugs you use are on your plan’s formulary.
  • Whether you get extra help paying your Medicare Part D costs.

Key Reminder

If your Medicare Advantage Plan (Part C) includes prescription drug coverage and you join a Medicare Prescription Drug Plan (Part D), you’ll be disenrolled from your Medicare Advantage Plan and returned to Original Medicare. If you decide not to join a Medicare Prescription Drug Plan when you’re first eligible, and you don’t have other creditable prescription drug coverage, or you don’t get Extra Help, you’ll likely pay a late enrollment penalty.

Benefits of a Prescription Drug Plan

When you enroll into Medicare you don’t automatically get prescription drug coverage. Original Medicare Parts A and B don’t include prescription drug coverage, that’s why almost every senior has a prescription drug plan (either Medicare Part D or a Medicare Advantage plan). Getting your medication at little to no cost is important for living a healthier life as you age. Each plan includes coverage for thousands of commonly used generic and brand name prescription drugs, but offer slightly different coverage and drug lists. Here are some of the benefits that a prescription drug plan has to offer:

  • Great value and coverage for most commonly used prescription drugs
  • Low annual deductibles.
  • Drug list includes most generic drugs and commonly used brand name drugs
  • You pay no more than 58% of the total cost for generic drugs or 45% of the total cost for brand name drugs, for any drug tier during the coverage gap.
  • Copays as low as $0

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