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A Guide to Enrolling in Medicare Part D

When nearing Medicare eligibility, it can be difficult to decide how comprehensive healthcare coverage needs to be. Enrolling in Original Medicare (Parts A and B) is mandatory, while prescription drug coverage (Part D) is optional. It is possible to enroll in an optional Part C/Medicare Advantage plan instead of Parts A, B and D, as it covers the mandatory Parts A and B (and usually includes drug coverage as well).

The first thing to decide is if Medicare Part D is this right fit. Part D will help pay for prescription drugs and protect you from high drug costs, both for medications taken today and in the future. Having some type of prescription drug coverage (either through a Part D or private Part C/MA plan) is crucial for most people. Almost everyone will take prescription drugs at some point in their lifetime. Many states have low-cost Part D plans designed to act as a safety net in case of future medication needs due to a change in health conditions. Choosing to not enroll in Part D upon eligibility at age 65, may create a lifelong penalty if enrollment is postponed.

Can you delay enrollment in Part D and keep your current drug coverage?

If you have prescription drug coverage through an employer, it is possible to delay enrollment in Part D without incurring penalties. The employer’s prescription drug plan can be kept until retirement or coverage loss if the plan allows for “creditable” drug coverage. This occurs when the employer’s drug plan is considered “as good as or better than” Medicare Part D. The employer can confirm eligibility to delay enrollment in a Part D plan. The insurance plan should also send a letter confirming if the company’s coverage is “creditable.” Any coverage considered “creditable” (to include a spouse’s employer or the Veteran’s Administration) allows for a delay in enrollment in Part D. For more information on delaying Part D enrollment, check out the “65 and still working” guide.

It is possible to enroll in Part C/Medicare Advantage instead of Part D to get drug coverage?

Medicare Advantage plans are private health plans that have contracts with Medicare. Joining one provides Medicare-covered healthcare services through the private plan. Medicare Advantage plans must cover all the same benefits as Medicare Parts A and B and may also cover prescription drugs. Enrolling in a Part C plan that covers prescription drugs will replace the need to enroll in Part D. Learn more about Part C.

Get access to free professional advice (from NCOA’s trusted partners) on finding the best Medicare plan.

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