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Part D RX drug coverage bottle

What is Medicare Part D Insurance?

Medicare drug coverage helps pay for prescription drugs you need. You'll pay a monthly premium to an insurance carrier for your Part D plan. In return, you use the insurance carrier’s network of pharmacies to purchase your prescription medications.

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What if I don't take any medications?

Even if you don’t take prescription drugs now, you should consider getting Medicare drug coverage to avoid possible penalties.  Keep in mind that Part D is insurance not just for your medications today. It also insures you for any new medications that your doctors prescribe in the future. 

Any Medicare beneficiary enrolled in either Part A and/or B can enroll in Medicare Part D. You must live in the plan’s service area as well.  All plans must cover a wide range of prescription drugs that people with Medicare take.

What you should know about Medicare Part D prescription drug plans

Your monthly plan premium and out-of-pocket expenses for prescription drugs will vary from plan to plan.

Every Medicare prescription drug plan has a formulary - that is, a list of covered drugs.  The formularies vary among plans.

Be aware that your plan may change its formulary. You may want to review the Annual Notice of Change that the plan sends you every fall to make sure it will still cover your prescription medications in the coming year.

What is the the Part D late enrollment penalty?

The late enrollment penalty is an amount that's permanently added to your Medicare drug coverage (Part D) premium. You may owe a late enrollment penalty if at any time after your Initial Enrollment Period is over, there's a period of 63 or more days in a row when you don't have Medicare drug coverage or other creditable prescription drug coverage . You’ll generally have to pay the penalty for as long as you have Medicare drug coverage.

The cost of the late enrollment penalty depends on how long you didn’t have creditable prescription drug coverage. Currently, the late enrollment penalty is calculated by multiplying 1% of the “national base beneficiary premium” by the number of full, uncovered months that you were eligible but didn’t enroll in Medicare drug coverage and went without other creditable prescription drug coverage. The final amount is rounded to the nearest $.10 and added to your monthly premium. Since the “national base beneficiary premium” may increase each year, the penalty amount may also increase each year. After you enroll in Medicare drug coverage, the plan will tell you if you owe a penalty and what your premium will be. 

3 ways to avoid the Part D late enrollment penalty
  • Enroll in Medicare drug coverage when you're first eligible.
  • Enroll in Medicare drug coverage if you lose other creditable coverage.
  • Keep records showing when you had other creditable drug coverage, and tell your plan when they ask about it.