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A couple deciding between the right drug coverage.

Medicare Part D Drug Coverage: Fitting All the Pieces in the Right Place

Parcheesi or Monopoly, Trivial Pursuit or Scrabble, checkers or chess? These choices are easy. Picking the right Medicare plan? That can be hard.

You know that feeling when you open a new jigsaw puzzle? You spread all the pieces out on a table. They face every which way. You know it will be hard to finish. But you also know if you stick with it, you’ll complete the picture—especially when you have some help.

When it comes to your prescription drug needs, Medicare can be just as hard to start. That’s because Original Medicare Part A (hospital insurance) and Part B (medical insurance) does not include drug coverage. You need to enroll in a separate drug plan, called Medicare Part D.

Private insurance companies approved by Medicare offer Part D plans. They add prescription drug coverage to Original Medicare. Prescription drug coverage is also included with most Medicare Advantage (MA) Plans.

Do You Need Part D Drug Coverage?

Like starting with the corner puzzle pieces and filling in the edges, it’s best to start with what’s easiest. Before enrolling in a Part D plan for your prescription drug needs, figure out if it seems like the right choice.

  1. Are your prescriptions already covered by insurance you have through a union, employer, or your military service? Find out if it is creditable prescription drug coverage. That’s coverage that pays, on average, at least as much as a prescription drug plan. If so, you may not need to purchase a prescription drug plan.
  2. Do you have or are you considering an MA plan (also called Part C)? If you want drug coverage, be sure the MA plan offers it.
  3. Do you have Medicare Supplement Insurance, often called a Medigap plan? A Medigap plan is a policy sold by private insurance companies. They only work with Original Medicare. Medigap plans help fill in the gaps that Original Medicare doesn’t cover. Does your Medigap plan offer drug coverage? If not, you’ll need to purchase a separate drug plan (Part D).
  4. Do you have Medicare and a Federal Employee Health Benefits (FEHB) plan? Most likely you already have drug coverage and don’t not need Part D.
  5. Do you only have Original Medicare (Part A and Part B)? You’ll need to purchase a Part D plan to help with prescription drug costs.

If You Need to Enroll in a Part D Drug Plan

Now it’s time to sort out all the puzzle pieces. There are dozens of Part D plans to choose from. These steps can help you find which one is right for you.

  • Step 1. Gather your information. Make a list of all prescription medications you take and the pharmacy locations you want to use.
  • Step 2. Visit www.MedicareSupportCenter.com and click the Plan Finder option at the top. Follow the steps and find which plans offered cover your medications in your service area.
  • Step 3. Consider a plan’s cost, convenience and coverage.
  • Note the monthly premium amount. It differs from plan to plan.
  • Add the monthly cost of each drug in the plan you’re considering. In Part D plans, you pay a set amount for each prescription until you reach the annual deductible. The deductible varies by plan selected.
  • Figure out how much you will need monthly to pay for your prescriptions (until you reach the deductible), plus the premium.
  • Make sure pharmacies offered by your plan are near you. Check and see if your plan offers a preferred pharmacy. They offer a lower drug cost. Another option is getting medications mailed to you. Does your plan offer mail order? This is important if you live in another state part of the year or take extended trips.
  • Research the plan’s Star Rating using the Plan Finder tool on www.MedicareSupportCenter.com. It’s a government-based rating system that scores how well Medicare plans perform for their members.

Complete the Picture by Considering Your Needs Now and in the Future

Even if you don’t need any prescription medication right now — good for you! But chances are you will in the coming years. According to the Merck Manual, ninety percent of older adults take at least one prescription drug. If you don’t get drug coverage when you’re first eligible for Medicare and don’t have creditable prescription drug coverage, you may pay a lifetime monthly penalty charge when you enroll later.

Want some help putting together your Medicare puzzle?

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