How to Enroll in Medicare Part D
How do I enroll in Medicare Part D?
Medicare Part D is prescription drug insurance that provides protection for people enrolled in Medicare who have high drug costs. Medicare Part D plans cover both brand name and generic prescription drugs at participating pharmacies in your area. Everyone with Medicare is eligible for Part D coverage, but coverage is not automatic. If you wish to receive prescription drug coverage, you must enroll in either a standalone Prescription Drug Plan (PDP) or a Medicare Advantage Prescription Drug (MAPD) coverage plan, offered through private insurance companies. A PDP only covers prescription drugs and does not cover hospital or medical services. MAPD plans provide both prescription drug and health insurance coverage.
Alignment Health Plan offers MAPD plans, meaning that Part D coverage is included, along with other extras that come with Medicare Advantage. The Centers for Medicare & Medicaid Services (CMS) rates all health and prescription drug plans each year, based on a plan’s quality and performance. Medicare star ratings help you know how good a job your plan is doing; you can use these star ratings to compare your plan’s performance to other plans. The main star ratings to focus on are the plan’s overall rating, which combines all of the plan’s scores, and the plan’s summary star ratings, which focus on the plan’s medical or prescription drug services. You can view Alignment Health Plan’s star ratings online.
Once you have selected your plan, you can use either the phone or computer to enroll yourself, or contact a licensed broker. To sign up over the phone, you can call Medicare 1-800-633-4227 (TTY users can call 1-877-486-2048) or call the plan directly. To enroll online, you can go to the Medicare Plan Finder and click the “enroll” button shown next to the plan's name, or enroll directly on the plan’s website.
Can I enroll in Medicare Part D anytime?
There are specific times when you can enroll or make changes to your Medicare prescription drug coverage. If you are looking to enroll in Medicare Part D for the first time, typically you will do so during your initial enrollment period when you first become eligible for Medicare Part D coverage, the annual fall enrollment period or a special enrollment period, which you must qualify for.
The initial enrollment period for Part D coverage typically falls during the same time that you become eligible for Medicare Part B coverage, which is a seven-month period that starts three months before you turn 65, and ends three months after. If you miss your opportunity to sign up for prescription drug coverage when you are first eligible for Part D, a penalty may be applied.
The annual enrollment period in the fall between October 15 to December 7 also allows you to change your Medicare prescription drug coverage, with new coverage beginning January 1.
A special enrollment period allows you to make changes to your Medicare Advantage or Medicare prescription drug coverage when certain life events, such as moving or losing prescription drug coverage, occur.
Remember that prescription drug coverage is offered only by private insurance companies, either as a standalone Part D plan or combined with Medicare Advantage in an MAPD plan. You cannot be enrolled in both at the same time. If you are currently enrolled in Original Medicare with a standalone PDP and enroll into a Medicare Advantage plan that includes drug coverage, your PDP coverage will automatically end when your new coverage begins.
Explore your options for Medicare Part D
Making Medicare decisions is an important step toward transitioning into retirement. With the different plans to choose from and the amount of information available, it's easy to get overwhelmed by the process. There are several factors to consider when deciding whether to enroll in prescription drug coverage when you first become eligible. If you decide to wait, and there is a lapse in coverage, you will likely have to pay a late enrollment penalty calculated by CMS for as long as you have Medicare prescription drug coverage. Plans will vary in cost and the drugs they cover. To choose a prescription drug plan that works for you, start by looking at your priorities:
- Do you take specific drugs? Review the plan’s drug list, or formulary, and compare costs.
- Do you want extra protection from high prescription drug costs? Check if the plan offers coverage in the “coverage gap,” also known as the “donut hole,” and see if the prescriptions you take are covered in the gap.
- Do you take generic prescription drugs? Many plans like Alignment Health Plan offer tiers that charge zero or low copays for generic prescriptions.
- While you may not have many drug costs now, do you want coverage for peace of mind and to avoid future penalties? Look for plans that offer low monthly premiums. Alignment Health Plan offers Medicare Advantage plans with built-in prescription drug coverage, many that have low to no monthly premium.