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Medicare Drug Coverage

Medicare Drug Coverage

Medicare drug coverage helps pay for prescription drugs you need. Even if you don’t take prescription drugs now, you should consider getting Medicare drug coverage. Medicare drug coverage is optional and is offered to everyone with Medicare. Suppose you decide not to get it when you’re first eligible. You don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help. 

In that case, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare drug coverage. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered. Visit Medicare.gov/plan-compare to find and compare plans in your area. There are two ways to get Medicare drug coverage: 
1. Medicare drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee-for-Service Plans, and Medical Savings Account Plans. You must have Part A and Part B to join a different Medicare drug plan. 
2. Medicare Advantage Plans or other Medicare health plans with drug coverage. You get all of your Part A, Part B, and drug coverage through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage. In either case, you must live in the service area of the plan you want to join. Both types of plans are called “Medicare drug coverage.”
Medicare drug coverage (Part D) If you have employer or union coverage, call your benefits administrator before making changes or signing up for other coverage. If you sign up for other coverage, you could lose your employer or union health and drug coverage for you and your dependents. If this happens, you may not be able to get your employer or union coverage back. If you want to know how Medicare drug coverage works with other drug coverage you may have, see page 84. When can I join, switch, or drop a plan? You can join, switch, or drop a Medicare drug plan or a Medicare Advantage Plan with drug coverage during these times: 

• Initial Enrollment Period. When you first become eligible for Medicare, you can join a plan. 

• Open Enrollment Period. From October 15 – December 7 each year, you can join, switch, or drop a plan. Your coverage will begin on January 1 (as long as the plan gets your request by December 7). 

• Medicare Advantage Open Enrollment Period. From January 1 – March 31 each year. 

If you’re enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or switch to Original Medicare (and join a different Medicare drug plan) once during this time. If you have to pay a premium for Part A and enroll in Part B for the first time during the General Enrollment Period, you can also join a plan from April 1 – June 30. Your coverage will begin on July 1. Special Enrollment Periods Generally, you must stay enrolled in your plan for the entire year. But when certain events happen in your life, like if you move or lose other insurance coverage, you may qualify for a Special Enrollment Period. You may be able to make changes to your plan mid-year if you qualify. 

How do I switch plans? You can switch to a new Medicare drug plan or Medicare Advantage Plan with drug coverage simply by joining another plan during one of the times listed above. Your old drug coverage will end when your new drug coverage begins. You should get a letter from your new plan telling you when your coverage begins, so you don’t need to cancel your old plan.