Part D (prescription drug coverage)
Medicare Part D (prescription coverage) are managed by individual insurance companies that contract directly with Medicare. This coverage helps cover the cost of prescription medication and some vaccines.
Drug plans must offer the following:
- Two options for each therapeutic category
- Deductible and copayment/coinsurance apply
- Drug formularies differ from company to company
- Max out of pocket or catastrophic coverage included
IMPORTANT NOTE: Penalties apply if you do not enroll in Part D coverage when first eligible. Over the counter medications, vitamins, weight loss supplements, and hair growth medications are not usually covered
Example: If you decline drug coverage when first eligible in 2021, you will pay a penalty of $.3306 X the number of months without coverage. If you went 10 years without a drug plan that’s 120 months X .3274 = $39.67 added to your premium of the drug plan. This would make a premium of $33.06 actually be $72.72 with the penalty.
Medicare Enrollment
There are 3 main enrollment times for Medicare.
Initial Enrollment Period
- This is the 3 months prior to the month you turn 65 and the 3 months following the month you turn age 65.
Special Enrollment Period
- Anytime you’re covered under a group plan.
- The 8-month period begins the first month after employment ends or group coverage ends.
General Enrollment Period
- The Medicare general enrollment period is from January 1 – March 31 of each year.
- Coverage from the general enrollment period won’t start until July 1 of the year you enroll.
Important note: Late fees and penalties apply to those who do not enroll when first eligible.