Do I need Medicare Part D?

Medicare Part D is prescription drug coverage that is offered to everyone with Medicare. The purpose of Part D is to help you pay for prescriptions. Premiums, copays, and drugs coverage vary from plan to plan, but all must meet basic requirements set out by Medicare. Drug coverage is generally built into Medicare Advantage plans. There are also plans without the medical component.

I don’t take any drugs, or only inexpensive drugs. Why should I pay for a plan?
Two reasons: 

  1. Your situation may change and you may need to start taking prescription drugs or need more expensive drugs. Most people can only sign up for a plan when they first get Medicare Parts A and B, or during annual ernrollment, from October 15 to December 7 each year. So, if your doctor wants you to go on a new medication in January, you may not be able to get any coverage until the end of the year.
  2. There is a penalty if you don’t join a plan when first eligible. That penalty is 1% of the “national base beneficiary premium” for each full month when you were eligible but did not have creditable coverage. This penalty sticks with you as long as you have Part D, and will change when the base premium changes.

How can I avoid the penalty and the risk of not having coverage when I need it?

  1. Get coverage during your initial enrollment period, which starts the third month before the month of your 65th birthday and ends the third month after your birth month.
  2. If you have employer or union-based coverage, you have a special enrollment period of two months after that coverage ends.
  3. Don’t go more than 63 days without a Part D plan or other creditable coverage. Examples of creditable coverage include retiree plans from a former employer or union, Pennsylvania’s PACE program for seniors with low incomes, and VA drug coverage. If you have one of these and lose it, you have 2 months to get a new plan without penalty. 
  4. If you qualify for assistance through Extra Help or Medicaid, you can join a drug plan without penalty at any time

Show All Answers

1. What is Medicare's Annual Open Enrollment Period?
2. How and when do I enroll in Medicare?
3. How does Medicare work with employer based insurance?
4. Am I covered by Medicare if my spouse or I is employed?
5. When can I switch my Medicare plan?
6. Does Medicare Cover COVID-19 Costs?
7. Do I need Medicare Part D?
8. Does Medicare cover vaccines?
9. What if one or more of my drugs is no longer covered by my Medicare drug plan?
10. What happens if you lose your Employer Group Health Plan when you are eligible for Medicare?
11. What's new for 2023?
12. When are the Medicare General Enrollment Period and the Medicare Advantage Open Enrollment Period?
13. How do I avoid Medicare scams?
14. What are 5-Star plans and when can I enroll?
15. How can I get help paying for Medicare Part B and Part D?
16. What are the different parts of Medicare?
17. How do I update my contact information if I'm moving?
18. Can I change my Medicare Advantage or Medicare Prescription Drug Plan anytime?
19. How do I create a Medicare account?
20. What are the benefits of the Inflation Reduction Act (IRA) of 2022 for Medicare beneficiaries?