If you have no drug coverage, or have drug coverage that is not as good as Medicare’s (i.e. not creditable), the Medicare Part D prescription drug benefit may help you. Even if you do not take prescription drugs, it is important to enroll in Part D so that if you later need to access prescription drugs you do not face late enrollment penalties or delays in enrolling.
If you currently have drug coverage that is at least as good as or better than the Medicare drug benefit (i.e. your coverage is considered creditable) and you like it, you probably should keep it. If you join a Medicare prescription drug plan, you may lose your creditable drug coverage and be unable to get it back later. At the same time, so long as you currently have creditable coverage, you can join a Medicare Part D plan later without penalty. The company that provides your drug benefits—such as an insurance company, employer, or state program—should send you written notification once per year telling you whether your coverage is creditable. Be aware that this information may not come as a separate piece of mail; it can be included with other materials, such as a plan newsletter.
If you are not notified whether your drug coverage is creditable, call and ask for an answer in writing. You will not have to pay any Part D enrollment penalties if you can show you received inadequate information about whether your drug coverage was creditable.
If you have other insurance coverage from a current employer or former employer (retiree coverage), you should ask your human resources department, benefits manager, or plan if and how your current coverage works with Part D. Some employer plans do not work with Part D at all, meaning that if you join a Part D plan you could lose your employer coverage and not be able to get it back.
Find out whether your state offers a state pharmaceutical assistance program (SPAP). Many state assistance programs coordinate with the Medicare prescription drug benefit and help with the costs of Part D coverage. While SPAPs often require that you enroll in Part D, a few states have programs that do not require you to enroll in a Part D plan and offer good coverage that is creditable. You can delay enrolling in Medicare Part D without penalty in these states. If your state’s SPAP is creditable, they must send you a written notification. If you do not receive a notification but believe your SPAP is creditable, you should call and request information in writing.