If you are eligible for Medicare and receiving benefits, you are also eligible for Medicare Part D. Part D is a form of Medicare that covers prescription drugs. It is completely optional compared to Medicare Part A and Medicare Part B, the two parts of the coverage that virtually everyone enrolled in Original Medicare will be covered by. This is because there are some beneficiaries who will not need extensive drug coverage and others who may require regular prescriptions. Medicare drug coverage helps defray the costs of these prescriptions, although it can be more complex than other areas of Medicare.
One of the most important issues that arise in regards to Medicare Part D coverage is when you enroll. For Medicare prescription drug coverage, you must choose to enroll when you are first eligible — during the “open enrollment” period that pertains to your 65th birthday. This period usually takes place between the middle of October and early December. If you choose to enroll at any other time of the year, you might find yourself paying an extra, percentage-based fee in order to recover your benefits. That means that you won’t get to enjoy your complete benefits until the following year.
For this reason, it can be a good idea to enroll in Medicare Part D even if you don’t have many prescriptions. Part D will then be available for you if your drug requirements change later in the year. Otherwise, you will have to pay for your prescriptions out of pocket or enroll later. It is also important to note that Part D is considered a part of Original Medicare. Although you can receive prescription drug coverage from private insurers as part of a Medicare Advantage plan, this is not generally referred to with the same terminology. They are sometimes called MA-PD plans.
In order to qualify for Medicare Part D either as a Medicare Advantage or Original Medicare plan, you must be receiving benefits under both Part A and Part B. If you are not yet enrolled in these plans, you cannot receive Part D. In order to understand exactly what Part D will cover and whether it covers the medications that you need, you should consult the document known as the “formulary.” This is a list of prescription medications divided into “tiers” — each tier has a cost associated with it, with some prescriptions being more expensive than others, even under Medicare protection.