Medicare Part D offers you a wide range of plans designed to fit almost every need and budget. Prescription drug plans (PDP) are part of Medicare but are only available from private insurance carriers. When you enroll in original Medicare and purchase a Medigap plan you should consider signing up for Medicare Part D at the same time.
You are not required to buy a drug plan, but if you do not buy one when first eligible you will be responsible for paying a late enrollment penalty.
Medicare Part D
Medicare offers prescription drug coverage (Part D) to everyone with Medicare. To get Medicare Part D drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.
What kind of Medicare Part D plan should I buy?
Medigap policies do not include a prescription drug benefit. If you want prescription drug coverage you may want to talk to Medicare about prescription drug plans or visit Medicare Drug Formulary Plan Finder
Medicare Plans of Georgia is happy to assist our Medigap clients in finding the right PDP that fits their needs and budget.
Many seniors will not need a prescription drug plan. Or they may want to order some of their medication outside of their Medicare Part D plan to save money. Many times it is less expensive to pay for your medication out of pocket, or use a mail order pharmacy. There are also many programs available to provide medications for little or no charge.
Medicare Part D Eligibility
Eligibility for Medicare Part D is only for individuals who do not already have “creditable” prescription drug coverage. Creditable prescription drug coverage (for example, from an employer or union) is coverage that is expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage.
If you currently have a high deductible plan that coverage may not be considered creditable by Medicare.
If you do not have creditable prescription drug coverage and you do not enroll in a Part D plan or a Medicare Advantage plan with prescription drug coverage when you are first eligible, you may be required to pay a “late enrollment” penalty if you later enroll in a Part D plan.
Here are some scenarios that may be considered as creditable prescription drug coverage:
- Covered by pension program. Some Americans receive prescription drug coverage as part of their pension package. They would normally not be eligible for Medicare Part D.
- Covered by employer. If a Medicare enrollee is currently employed and his or her employer provides prescription drug coverage, they would normally not be eligible for Medicare Part D.
- Covered by union. Many unions offer prescription drug coverage for their retired members. They would normally not be eligible for Medicare Part D.
- Medicare Advantage. Many Medicare Part C (Medicare Advantage) programs already include prescription drug benefits. They would normally not be eligible for Medicare Part D.