What's Part D? đź’Š

“What’s Medicare Part D and do I need it?” is a question we receive often. Medicare Part D is Medicare Prescription Drug coverage. Medicare Part D is the insurance piece that helps cover the costs of prescription medications. Medicare Part D can either be purchased in a standalone Part D plan or included in a Medicare Advantage (Part C) plan. We remind our clients when they hear Part D just think D=Drug.

Medicare Part D coverage is not automatic, which means you have to select and enroll in a Medicare Part D plan available in your county.

Part D can arguably be considered one of the most confusing pieces of the Medicare puzzle that prompts questions like:

  • Do I need Part D even if I'm not on any medications or taking any prescriptions?

  • How do I know what Part D plan is the right fit for me?

  • Does Medicare Part D cover all of my prescription drug costs?

We're going to answer those questions in the blog post today.

Do I need Part D even if I'm not on any medications or taking any prescriptions? Yes, you need to select and enroll in a Part D plan even if you are not currently taking any medications. Why? Because let's say you do not enroll in a Part D plan and you go to a doctor's appointment and they prescribe you something. If you do not have any insurance you will pay full retail cost for the medication unless you are lucky enough to get samples at the office or are able to use a manufacturer coupon. However, that's not a risk we recommend taking. Also, the government will penalize you if you do not have Part D coverage and do not carry creditable coverage elsewhere. What's the penalty? The penalty is by multiplying 1% of the "national base beneficiary premium" by the amount of full months you did not have coverage.

How do you know what Part D plan is the right fit for you? First, you want to make sure your plan covers your current medications and allows you access to your desired pharmacy. This part can get a little confusing, so we recommend working with a licensed agent specializing in Medicare to help evaluate and review what options may be suitable for your current prescription drug needs. You can review and change your Part D plan every year during the annual enrollment period, which is 10/15-12/7. If you've had significant changes throughout that year that may be a good time to sit down with someone and make sure you aren't overpaying for your medications.

Does Medicare Part D cover all of my prescription drug costs? No, Medicare Part D does not cover all of your prescription drug costs. You have your premium (if applicable) to be enrolled in a Part D plan and then you may have a deductible stage and after that you pay whatever the assigned copayments are for your tier of medication(s). The lower the tier of your medication like a preferred generic or generic medication the less expensive the copayment is. If you are someone who is on several medications or expensive medications it's important to work with someone you trust to find a plan that works best for your needs and budget.

Questions about Part D or Medicare? Contact Jocelyn Wolf, Licensed Sales Agent Specializing in Medicare & Co-Founder of Evolve Insurance Group, at 814.201.9708 or jocelyn@evolveinsurancegrp.com.

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Other Medicare Questions? We can be reached at 814.201.9708 or at jocelyn@evolveinsurancegrp.com.

Jocelyn Wolf