Part D – Is it necessary?

Medicare Part D is prescription coverage.  Although Medicare Part D is regulated by CMS, the plans are only available through private insurance.

Even though you think you may not need prescription coverage, it is important to learn about the penalty you may incur later if you don’t enroll.

Medicare Part D can be purchased as a stand-alone policy, or can be administered through Medicare Advantage (combining all the Parts of Medicare into one plan).

Medicare Part D Benefits Explained

Eligibility

You first become eligible for Medicare Part D the same time you’re eligible for Medicare Parts A & B. You have a 7 month window to enroll. This window begins three months prior to your 65th birthday month, includes your birthday month, and three months after.

This works the same if you are under 65 and disabled (except, instead of your birthday month, your 7 month window starts three months before your 25th month of disability).  You will later get a another 7 month enrollment window when you turn 65.

You can also enroll in or change your prescription drug plan each year during the Annual Election Period.  The AEP dates are October 15th-December 7th.

Eligibility and enrollment rules are the same for stand-alone Part D plans, and Medicare Advantage.  Enrolling in one will cancel your existing Part D or Medicare Advantage plan, so you may want to seek assistance before enrolling online.

We offer a few Medicare Part D Plan Options, and there are many more that you can explore through Medicare.gov.

What can I expect to spend?

Sample pricing taken from Medicare.gov for the Tampa Florida area shows a stand-alone Part D plan as low as the $18 range.  The average drug plans range from $25-$50 per month.  Some of the lower priced plans have an annual deductible.  

Keep in mind that stand-alone Part D plans are only for individuals on Original Medicare, OR Original Medicare plus a Medigap policy.  Stand-alone drug plans are NOT compatible with Medicare Advantage Plans.

Enrolling in a Plan

Medicare.gov will give you a complete listing of drug plans available in your zip code, including monthly premium, deductible if any, plan copays, and plan ratings.

We offer free assistance entering your drugs online to search plans according to cost and coverage of your personal prescriptions.  This is something we can do for you quickly and easily.

If you’d like more in depth cost analysis, and confirmation that your specific drugs will be covered, call or email for assistance.

You may also perform this search yourself on Medicare.gov and enter in each of your prescriptions.

Medicare.gov provides customized annual costs for each drug plan available in your zip code, based on the drugs you enter. This feature is invaluable for those with potentially costly prescriptions, and those who have reached the coverage gap in the past.