Medicare Prescription Drug Coverage Part D
Medicare Part D is coverage for retail prescription drugs that you obtain from a retail pharmacy. Part D is provided only through private insurance companies that have contracts with the federal government—it is never provided directly by the government (unlike Original Medicare).
The monthly premiums for Part D drug plans vary depending on the specific plan that you choose. Each insurance company sets its own rates. There is a cost-sharing that you will pay at the pharmacy for your medications. That cost-sharing may include some deductible spending if your Part D plan has a deductible.
If you want Part D coverage, you must select and enroll in a private Medicare prescription drug plan (PDP) or a Medicare Advantage Plan with drug coverage (MAPD). Enrollment (outside of a Medicare Advantage plan) is optional (though recommended to avoid incurring future penalties) and only allowed during approved enrollment periods. Typically, you should sign up for Part D when you first become eligible to enroll in Medicare.
Whether you should sign up for a Medicare Part D plan depends on your circumstances. You may have creditable drug coverage from employer or retiree insurance. If so, you do not need to enroll in a PDP until you lose this coverage.
There are many prescription drug plans available. The stand-alone plans should be examined annually during the AEP (Annual Enrollment Period), comparing the cost and benefit of each plan, based on your mix of medications. Those with Medicare Advantage plans generally have their Prescription Drug plan provided with their Advantage Plan and do not have the choice of a stand-alone plan.
Additionally, there are programs such as Low-Income Subsidies (LIS) for qualifying beneficiaries with limited resources.
Revisit your choices every year. From October 15 through December 7 annually, Medicare has an open enrollment period for current enrollees. Use this time to review your coverage and evaluate whether it still suits your needs. It is particularly important to look at your prescription drug coverage. Do you still have the best choices for prescription coverage given the drugs you take? Insurance carriers can and do change their formularies, preferred provider pharmacies, and prices each year.