What is Medicare Part D?

Medicare Part D is your Medicare prescription drug coverage. Just as Medicare Part A covers your hospital services and Medicare Part B covers your doctor bills, Medicare Part D covers your prescription drugs. However, keep in mind that you do not automatically receive Medicare Part D when you sign up for Medicare. Medicare Part D is entirely voluntary. If you want it, you must enroll through a provider.

Who is eligible for Medicare Part D?

If you are eligible for Medicare, then you are eligible for Medicare Part D coverage. That means that if you are age 65 or older or if you are on Medicaid or Medicare because of a disability, you are eligible for Medicare Part D prescription drug coverage.

When can I sign up for Medicare Part D?

As soon as you turn 65 you are eligible for Part D prescription drug coverage. Your first opportunity to sign up will be 3 months before your 65th birthday. We recommend that you sign up at least one month before your 65th birthday to make sure that your information is in the system and so that you can take full advantage of all that Medicare part D has to offer. Please also note that there is a late penalty if you decide to enroll 6 months after you are first eligible.

What drugs are covered under Medicare Part D?

You should be aware that every plan’s coverage will differ slightly and you should always check to make certain that the drugs you need are covered. Generally however, Part D covers drugs available only by prescription, approved by the Food and Drug Administration (FDA) and used and sold in the United States. Part D drugs include prescription drugs, biological products, insulin, vaccines, and certain medical supplies associated with the injection of insulin (syringes, needles, alcohol swabs, and gauze). In addition, any drug covered by Medicare Parts A or B will not be covered by Part D.

How much does Medicare Part D cost?

Once again, each plan differs slightly, but you can expect to pay a small premium each month, then, after your deductible is met, Medicare will pay your health insurance provider for a large part of your prescription drugs. Extra help is available of course. Those with low incomes or limited assets may be eligible to receive financial assistance including reduced premiums, deductibles, and co-payments.

What if I’m already covered by a prescription drug plan?

If you already have drug coverage through another plan you are certainly welcome to continue with that plan. Once again, Part D is voluntary. However, you may only be enrolled in one drug plan at a time. It is probably wise to compare plans, drug coverage, costs etc. and choose the one that is right for you. You will find that your health insurer plans really are quite comprehensive in their drug coverage as well as very competitively priced.

What pharmacies can I use?

Like all Medicare Part D plans has enlisted a large network of pharmacies from which you can choose. You must use a network pharmacy to receive plan benefits. Your drug prescriptions will not be covered if you use an out-of-network pharmacy, except in certain cases (examples are a medical emergency or urgent care or when a network pharmacy is unavailable.) These network pharmacies have agreed to fill prescriptions for our members. Network pharmacies will also be happy to file your Medicare prescription drug claims for you.