A. Those eligible for Medicare have 2 options: A stand-alone Medicare Part D prescription drug plan or an "all-in-one" approach with a Medicare Advantage plan. Here we will focus on Medicare Part D. There are two scenarios when you consider Medicare Part D:
1. If you currently take prescription drugs
Not all Part D plans are created equal. Each plan varies in terms of cost, the drugs covered, special rules, and so on. Just because a friend or family member's Part D plan works for their needs doesn't mean it will work for yours. Instead, do some homework. Here are 5 simple steps to get started.
- Make a list of your current prescription drugs, including the dosage, quantity (30-day supply, 60-day supply, etc.) and frequency (how often you take them).
- Take your list to the Medicare Plan Finder at Medicare.gov. It can show you which Part D drug plans are available in your area and which of those plans cover your drugs. (You can also use the Plan Finder each year to check your current Part D plan and see if better options are available.)
- Once you find plans that cover your prescriptions, see how much they will cost you. Costs are typically your monthly premium (what you pay to have the Part D plan) and any out-of-pocket amount you pay for a drug. While a Part D plan may cover your prescriptions, you may wind up paying more compared to other plans, depending on which pricing tier the plan places your prescriptions (referred to as a drug formulary).
- Your share of the prescription drug costs can fluctuate based on your drug's category (generic or brand). Part D plans usually spell out this information in their plan details. If you want to choose a plan with a low monthly premium, make sure to consider the plan's total cost (premium plus out-of-pocket costs) per year.
- Check out the Part D plan's ratings. Medicare gives Part D plans a rating of 1 start (poor) to 5 star (excellent) based on customer service, customer experience and complaints, performance, drug safety, and pricing accuracy. These ratings can help you know how good a job the plan is doing in providing coverage. Keep in mind new plans might not have a rating.
2. If you currently do not take any prescription drugs
Even if you don't take prescription drugs currently, if you need them later and you try signing up for a Part D plan late, you could face a penalty of 1% for each month you went without coverage. Not having Part D coverage could be a costly—and long-term—mistake.
You should consider enrolling in a Part D prescription drug plan as soon as you become eligible for Medicare (unless you have creditable drug coverage such as from an employer health plan), regardless of your current prescription drug needs.