Medicare: Part D

Your Prescription Drug Options

How does Part D work?

On January 1, 2006, new Medicare prescription drug coverage (Part D) became available to everyone with Medicare, regardless of income, health status, or how you pay for your prescription drugs today.

Everyone with Medicare needs to make a decision about prescription drug coverage. Even if you don't use a lot of prescription drugs now, you should still consider joining a plan.

Remember, to get the coverage, you must join a plan.

How does Medicare prescription drug coverage work?

Your decision about Medicare prescription drug coverage depends on the kind of health care coverage you have now. There are two ways to get Medicare prescription drug coverage. You can join a Medicare prescription drug plan or you can join a Medicare Advantage Plan or other Medicare Health Plans that offer drug coverage.

Whatever plan you choose. Medicare drug coverage will help you by covering brand-name and generic drugs at pharmacies that are convenient for you.

Like other insurance, if you join, you will pay a monthly premium, which varies by plan, and a yearly deductible (no more than $480 in 2022). You will also pay a part of the cost of your prescriptions, including a co-pay or coinsurance, and drugs during the "Gap" period in some cases. Costs will vary depending on which drug plan you choose. Some plans may offer more coverage and additional drugs for a higher monthly premium. If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible.

Who can get Medicare prescription drug coverage?

Everyone with Medicare is eligible for this coverage, regardless of income and resources, health status, or current prescription expenses.

What if I can't afford Part D premiums or related expenses?

Because there are out-of-pocket costs associated with the new Medicare prescription plans, Medicare, via the Social Security Administration, has an application for people who might be eligible for financial assistance. This application, called "Extra Help", assists people with the Medicare Part D monthly premium, deductible, and co-pay.

The Extra Help application is available from Social Security or contact your local Social Security office to request an application. Most local senior centers have copies of the application, as well.

When can I join a Part D plan?

Medicare Open Enrollment starts October 15 and ends December 7. You may also enroll 3 months before, the month of, and the three months after your 65th birthday, as long as you have elected to start your Part B at that time. Certain circumstances allow for special enrollment periods such as; moving out of the plans service area, loss of employer coverage, plus many more.

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