Enrollment in a Medicare Prescription Drug Plan (MA-PD) is never automatic, the only way you can get a Medicare Prescription Drug plan is through a private insurance carrier.

Premiums for Medicare Prescription Drug Plans will vary between different insurance carriers and companies may have several different drug plans, with different premiums and coverage levels.

Some Drug Program Characteristics include:
  • Monthly Premium:  Every prescription drug plan has a monthly premium that you can pay by check, automatic bank draft, or automatic deduction from your social security check.
  • Deductible:  Some prescription drug plans have a $400 calendar year deductible. These plans tend to have lower monthly premiums and lower co-payments. However, plans with deductibles can be unattractive for people who turn 65 late in the year as the deductible re-sets every year on January 1st.
  • Co-payments:  Every prescription drug plan available will have different co-payments for different prescriptions. Some plans will have preferred pharmacies that will offer lower co-payments for select plans.
  • Formulary:  Different prescription drug plans have different drug formularies and may cover medications that other plans may not. All plans are required to offer coverage for prescriptions in every therapeutic category.
  • Star Ratings:  The Center for Medicare Services (CMS) assigns star ratings to each plan. This allows consumers the ability to identify high performing plans from under-performing plans.
Penalties:

If you’re eligible for Medicare Parts A& B and don’t have creditable prescription drug coverage from an employer or other source, you’re eligible for Part D. If you decide not to have a Drug Plan, you will be penalized anytime you go a period of 63 days or more without a Medicare prescription drug plan or some other creditable coverage (from a former employer, for example).

For more information on the Part D late enrollment penalty, visit Medicare.gov or contact one of our licensed professionals who will help you understand what policies are available and the coverage you may qualify for and how much you’ll pay.