Medicare's prescription drug coverage (also called Part D) is a program to help people on Medicare pay for medicine. You can add Part D to Original Medicare. It can also be added to certain other Medicare plans. You can also get prescription drug coverage by enrolling in a Medicare Advantage Plan that offers it.
Most people who are 65 years and older or are disabled can enroll in Medicare. This includes Medicare drug plans.
You can enroll in Medicare 3 months before your 65th birthday or 3 months after. People who are disabled can enroll during a 7 month window around their 25th month of disability. Medicare also has an open enrollment period from October 15 through December 7.
Private health insurance companies manage the drug plans for Medicare. They provide a list of brand name and generic drugs that they cover. The list can change over time. It is common for drug plans to exclude more expensive brand name medications when a generic one can be found. However, if there is a medicine that you really need, your doctor may be able to appeal and get it covered.
The costs depends on many things, such as the medicines you use, the plan, and whether you go to a pharmacy in your plan’s network. Here are some costs you can expect to pay:
There are steps that you can take to lower your costs, such as:
By answering a few questions, you should be able to choose a plan that works best for you:
Visit the US Medicare website to learn more about their health plans and drug coverage. If you are eligible, you can even sign up for Part D online.
Drug coverage (Part D). Medicare website. Available at: https://www.medicare.gov/drug-coverage-part-d. Accessed October 19, 2021.
Enrolling at the right time. AARP website. Available at: http://www.aarp.org/health/medicare-insurance/info-04-2011/medicare-enrollment.html. Accessed October 19, 2021.
Extra help with Medicare prescription drug plan costs. Medicare website. Available at: https://secure.ssa.gov/i1020/start. Accessed October 19, 2021.
Get help paying costs. Medicare website. Available at: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs. Accessed October 19, 2021.
Medicare Advantage plans. Available at: https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans. Accessed October 19, 2021.
Medicare and you: 2022. Medicare website. Available at: https://www.medicare.gov/Pubs/pdf/10050-Medicare-and-You.pdf. Accessed October 19, 2021.
Last reviewed October 2021 by EBSCO Medical Review Board