In addition to Medicare A & B and purchasing a Medicare Supplement plan most Medicare beneficiaries will also need to pick up a plan to cover prescription medications. This is called Part D. Anyone who has Medicare Part A and/or Part B is eligible to pick up a drug plan at certain times in their life such as the three month window surrounding your birthday or during a special event like losing employer cover or moving out of state. Medicare beneficiaries can also elect or change their Part D drug coverage during the Annual Enrollment Period from Oct 15th – Dec 7th. It is important to pick up your prescription drug coverage when you are first eligible otherwise you may face a penalty for going without and face paying prescription costs out of pocket.

There are many insurance companies that offer Medicare Part D drug plans. In 2021, there were 28 Part D plans offered in the state of IA for beneficiaries to choose from. Coverage and prices range amongst the plans and there is no one size fits all plan. To find out which drug plan of the 28 is best suited for you we will use the Medicare.gov system to sort out the lowest costing overall plan that best covers your prescriptions and pharmacy. 

Here are some scenarios to consider:

What if you aren’t using any prescription medications and don’t want to pay for a drug plan? If you aren’t currently using any prescriptions it can seem like a waste to pay a monthly premium for a program you aren’t using. If you decide to go without credible drug coverage and someday want to pick up a drug plan you will likely face a Medicare Late Enrollment Penalty. The LEP is on average $0.33 for each month you went without credible coverage since becoming eligible for a plan. This penalty is added to the drug plan premium you purchase and stays with you for life. However, if you go your entire life without needing or purchasing a drug plan, you’ll never be penalized. We encourage our clients to consider their options and the repercussions of going without a plan. 

What if you are a veteran and get prescriptions through the VA? If you are a veteran and use the VA for your prescriptions your coverage through the VA counts as credible coverage in the eyes of Medicare. If you go without a Medicare Part D drug plan you will not have a penalty if you decide you want a Medicare Part D plan in the future. 

Can I change my Part D plan? YES! From October 15th – December 7th  (AEP) Medicare beneficiaries can check and change their prescription drug coverage for a January 1 effective date. It is a good idea to check your drug plan especially if you have added new prescriptions, use expensive brand names or just in general want peace of mind that you are still on the right plan. If you do not check your drug plan in the fall, typically your current Part D plan will automatically continue into the next year. Beneficiaries can check their own Part D plans using medicare.gov, have an agent like us do it for you, have your pharmacist or a volunteer with SHIPP check your plan. In addition to the annual enrollment period (AEP) Medicare members may also be able to change their drug coverage during certain situations such as if they qualify for Low Income Assistance, Medicaid, reside in a nursing home or institution or move out of state.