Medicare Part D
Medicare prescription drug coverage is optional and does not occur automatically. You can receive coverage for prescription drugs by either signing up for a stand-alone Medicare prescription drug plan or a Medicare Advantage plan that includes drug coverage, also known as a Medicare Advantage Prescription Drug plan. Medicare prescription drug plans and Medicare Advantage plans are available through private insurers. Please note that you cannot have a stand-alone Medicare prescription drug plan and a Medicare Advantage plan that includes drug coverage.
Initial Enrollment Period
You can enroll in a stand-alone Medicare prescription drug plan during your Initial Enrollment Period for Part D. You are eligible for prescription drug coverage if:
You live in a service area covered by the health plan, and
You have Medicare Part A AND/OR Medicare Part B.
Generally, your Initial Enrollment Period for Part D will occur simultaneously as your Initial Enrollment Period for Medicare Part B (the seven months that starts three months before your eligibility for Part B, includes the month you are eligible, and ends three months later).
Once you are eligible for Medicare Part D, you must either enroll in a Medicare prescription drug plan, Medicare Advantage Prescription Drug Plan, or have creditable prescription drug coverage (that is, prescription drug coverage that is expected to pay at least as much as standard Medicare prescription drug coverage). Some people may choose to delay Medicare Part D enrollment if they already have creditable prescription drug coverage through an employer group plan.
However, if you do not sign up for prescription drug coverage when you are first eligible for Part D, you may have to pay a late-enrollment penalty for signing up later if you go without creditable prescription drug coverage for 63 or more consecutive days.
Annual Election Period
If you did not enroll in prescription drug coverage during IEP, you could sign up for prescription drug coverage during the Annual Election Period (AEP) that runs yearly from October 15 to December 7. During AEP, you can:
Sign up for a Medicare prescription drug plan.
Drop a Medicare prescription drug plan.
Join a Medicare Advantage plan that includes prescription drug coverage.
Switch from a Medicare Advantage plan that doesn’t include prescription drug coverage to a Medicare Advantage plan that does (and vice versa).
Outside of the Part D Initial Enrollment Period and the Annual Election Period, usually the only time you can make changes to prescription drug coverage without a qualifying Special Election Period is during the Medicare Advantage Open Enrollment Period but only if you are dropping Medicare Advantage coverage and switching back to Original Medicare. The Medicare Advantage Open Enrollment Period runs from January 1 to March 31.
Medicare Part A and Part B do not include prescription drug coverage. If you switch back to Original Medicare during the Medicare Advantage Open Enrollment Period, you will have until March 31 to join a stand-alone Medicare prescription drug plan.