Medicare Prescription Drug Coverage

Prescription drug coverage is available to everyone with Medicare. To obtain it, you must join a plan administered by an insurance company approved by Medicare within 63 day after your Initial Enrollment period ends.

You or your senior loved one can join a Medicare Drug Plan during Initial, Yearly or Special Enrollment Periods. Should you decide not to join one, and don’t have other “creditable” prescription drug coverage, or get “Extra Help”, you’ll be subject to a late enrollment penalty. 

Part D Late Enrollment Penalty

That depends on how long you went without creditable coverage. It’s calculated by multiplying 1% of the “national base beneficiary premium” ($31.08 in 2012) times the number of months you were eligible but didn’t join a Medicare drug plan. The base premium can increase each year, as can the penalty amount.

Tip: To save money long-term and avoid the penalty, think about enrolling in a plan when eligible. You could always get a lower cost plan initially and upgrade later should need change. Consider that as we age, prescription medications often become a part of our daily routine…

Getting Medicare Drug Coverage

1. Stand Alone Medicare Prescription Drug Plans (“PDPs” or Part D) that add drug coverage to Original Medicare.

2. Medicare Advantage Plans or other Medicare health plans that offer the coverage built in (“MA-PDs”). You can join by enrolling on the Medicare Plan Finder or on the plan’s Web site, by completing a paper application, calling the plan or calling 1-800-MEDICARE. Have your Medicare card handy.

Know that if you currently have a Medicare Advantage Plan that includes prescription drug coverage and you join a Medicare Prescription Drug Plan, you’ll be automatically disenrolled from your Medicare Advantage Plan and returned to Original Medicare.

Information contained in this article is presumed accurate at the date of publication (06/2012), but not guaranteed. In addition, Medicare changes rules and costs annually so it’s important to refer to the paragraph above to access the most current data.

About the Author

Gary Phillips is a licensed insurance agent based in western North Carolina. He specializes in the senior market and is knowledgeable in multiple insurance lines including Medicare, Medigap, Long-Term Care, Part D Prescription Drugs, Part C Medicare Advantage, Health, Life and Final Expense insurance. He also enjoys writing and helping others.

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