If you want to get the Medicare prescription drug benefit, you must choose a private plan offering the benefit in your area and enroll in it. When choosing a Medicare private drug plan, make sure to look at all the costs, not just the premium. Your costs throughout the year will depend on what drugs you take, whether your plan covers them, and whether there are any coverage restrictions.
In most cases, you can only enroll in the Medicare drug benefit during specific annual enrollment periods. Enroll early during an enrollment period to make sure that your new coverage starts when it should.
There are two types of drug plans you can choose from depending on how you get your Medicare benefits. If you have:
- Original Medicare: Choose a stand-alone prescription drug plan (PDP) if you want to continue to receive your other health benefits through Original Medicare.
- Medicare Advantage Plan (such as an HMO or PPO): Generally, you must get Part D drug coverage as part of your Medicare Advantage Plan’s benefits package. (If you join a Medicare Medical Savings Accounts (MSA), Private Fee-for-Service (PFFS) plan without drug coverage, or a Cost Plan, you can also join a PDP.)
To enroll in a plan you can:
- Call 1-800-MEDICARE. Counselors are available to guide you through your plan options and enroll you in a plan. It is best to enroll through 1-800-MEDICARE to avoid administrative errors.
- Go to Medicare.gov, Medicare’s consumer web site has a plan-finder tool that lets you compare and enroll in a plan.
- Call the plan directly.
You can choose to have the premium, which may vary by plan, taken out of your monthly Social Security check or pay it directly to the company. In general, it is best to have your premium billed directly, not withdrawn from your Social Security check. However, if you do choose to have your premiums withdrawn from your Social Security check and there is a delay in paying the Part D plan, your plan cannot disenroll you or bill you for the premium.
No matter which option you choose, you may only be able to change plans once a year.
Note: If you have Extra Help, the federal program that helps pay most of the costs of the Medicare drug benefit, or live in a nursing home, you will be able to change your Medicare drug plan once a month.