How

How to Get Medicare Part D (Prescription Drug Plan)

Medicare Part D provides coverage for prescription medications and is available through private insurance companies approved by Medicare. Here’s how to get a Part D plan:

1. Determine Your Eligibility

To enroll in a Medicare Part D plan, you must:

• Be enrolled in Medicare Part A and/or Part B.
• Live in the service area of the Medicare Part D plan you want to join.

2. Understand Enrollment Periods

You can enroll in a Medicare Part D plan during specific periods:

Initial Enrollment Period (IEP)

• Starts three months before the month you turn 65.
• Includes your birth month.
• Ends three months after the month you turn 65.
• For those under 65 and disabled, the IEP is similar, starting three months before and ending three months after the 25th month of receiving Social Security or Railroad Retirement Board (RRB) disability benefits.

Annual Enrollment Period (AEP)

• From October 15 to December 7 each year.
• You can join, switch, or drop a Medicare Part D plan.
• Coverage begins on January 1 of the following year.

Medicare Advantage Open Enrollment Period (MA-OEP)

• From January 1 to March 31 each year.
• If you’re enrolled in a Medicare Advantage Plan, you can switch to another Medicare Advantage Plan or drop your Medicare Advantage Plan and return to Original Medicare and join a Medicare Part D plan.

Special Enrollment Periods (SEP)

• You may qualify for a SEP due to certain life events such as moving out of your plan’s service area, losing other credible drug coverage, or entering a nursing home.

3. Compare Medicare Part D Plans

Medicare Part D plans vary in terms of coverage, costs, and formularies (list of covered drugs). To compare plans:

• Visit the Medicare Plan Finder.
• Enter your ZIP code, current medications, and pharmacy preferences.
• Review plan options based on monthly premiums, deductibles, copayments/coinsurance, and pharmacy networks.
• Pay attention to the formulary and ensure your medications are covered.

4. Enroll in a Part D Plan

Once you’ve chosen a plan, you can enroll through:

• Online: Use the Medicare Plan Finder to enroll directly.
• Phone: Call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
• Paper Enrollment Form: Obtain a form from the plan provider, complete it, and return it as directed.
• Directly through the plan: Contact the insurance company offering the plan to enroll.

5. Consider Assistance Programs

If you have limited income and resources, you might qualify for Extra Help (Low-Income Subsidy, LIS) to assist with Part D costs, including premiums, deductibles, and copayments. To apply:

• Visit Social Security’s Extra Help page.
• Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
• Visit your local Social Security office.

Tips for Successful Enrollment

• Review Annually: Part D plans can change their formularies, premiums, and cost-sharing each year. During the Annual Enrollment Period, review your plan to ensure it still meets your needs.
• Keep Documentation: Maintain records of your enrollment and any communications with Medicare or your plan provider.
• Contact SHIP: If you need personalized assistance, contact your State Health Insurance Assistance Program (SHIP) for free counseling.

By following these steps, you can enroll in a Medicare Part D plan that best suits your prescription drug needs and budget. For more detailed information and assistance, visit medicare.gov or call 1-800-MEDICARE