Most Important Details About Medicare Part D Enrollment

Medicare Part D Enrollment

Medicare Part D provides prescription drug coverage for Medicare beneficiaries. The plan can also be referred to as a Medicare Prescription Drug Plan (PDP). Original Medicare (Parts A and B) does not provide coverage for most prescription medications, making a Medicare Part D plan beneficial to many people. Medicare Part D enrollment is an important part of your health care and shouldn’t be put off.

When Is Medicare Part D Enrollment?

There are several specific times that you can enroll in Medicare. The process is different than signing up for Original Medicare. There are three specific times when you can enroll. Those enrollment periods are:

The initial enrollment period when you qualify for Medicare.
Special enrollment periods when circumstances change significantly and allow for it.
Annual enrollment period when you can make changes to your plan each year

Initial Enrollment Period for Prescription Drug Plans (Part D)

For most people, the initial enrollment period is ideal to add a Medicare Prescription Plan (Part D). This begins on the first day of the month, three months before your 65th birthday. Your enrollment period is different than others as a result. This period lasts until the last day of the month, three months later.
Enrolling in Original Medicare is often the first step. You use that same timeframe to enroll in Medicare Part D. Review all of the providers of this coverage in your area to determine the best overall choice for you. You’ll want to consider factors such as the medications you use now and the types you may use in the future.

If you don’t want to enroll at this time, you can avoid doing so. However, it’s necessary to have a credible drug coverage plan in place, or you may pay a penalty. To find out if it meets Medicare qualifications, ask the plan provider to state that it meets the requirements of being credible.

Special Enrollment Period for Medicare Part D

You may be able to enroll in Medicare Part D when situations warrant making a change. For example, a life event may occur that eliminates the other prescription drug coverage you have in place. Various events may trigger this, including:

A significant change in where you live, changing who your providers are.
Losing current coverage for prescriptions.
Your current plan changes significantly, such as what it covers or costs.

Suppose a life event occurs that impacts your current prescription drug coverage. In that case, the special period may be allotted to provide you with a way to get Part D in place quickly. Medicare.gov provides a list of potential reasons why you may qualify for a special enrollment period.

Enrolling in Part D During Medicare’s Annual Enrollment Period

Each year from October 15th to December 7th, enrollment opens up for the following year. If you have Medicare Prescription Drug Coverage (Part D) at this time, you may wish to change coverage. If you no longer have credible drug coverage, this is an opportunity to get it in place. During this period, you can add prescription drug coverage, change your plan, or drop it fully.

Also note that on October 1st of each year, Medicare releases formulary changes that may impact your coverage. Review these as soon as possible so you can make changes to your policy if you need to do so.

Struggling with a New Medication?

A new prescription medication can cause a situation where you lack enough coverage with your current plan. Unfortunately, it’s not possible to be added to a plan or to change your plan outside of these three enrolment periods. You may be able to get some help from your pharmacists on ways to lower that drug cost, or you may want to speak to your doctor about other medications that are covered.

How Do I Enroll in Medicare Part D?

You don’t have to make decisions about Medicare coverage on your own. If your current prescription drug plan is not serving your needs, don’t wait to seek out help. It’s critical to understand enrollment periods and the reasons you may wish to make a change. Ask questions to get the information you need to make a wise decision.