Should You Enroll in Part D? A Guide.

September 1, 2015

Do I Need Medicare Part D?

If you are nearing Medicare eligibility, you know that it can be tricky to decide how comprehensive your healthcare coverage should be—especially if you’re in perfect health, or trying to cut down on medical costs. Enrolling in original Medicare (Parts A and B) is mandatory, while prescription drug coverage (Part D) is optional. You can also enroll in an optional Part C/Medicare Advantage plan instead of Parts A, B and D, as it covers the mandatory Parts A and B (and usually includes drug coverage as well).

So is a Part D plan right for you? If you take drugs now—or if your health changes and you need them in the future—Part D will help pay for your drugs and protect you from very high drug costs. Having some type of prescription drug coverage (either through a Part D or private Part C/MA plan) is crucial for the vast majority of people. In fact, almost everyone will take prescription drugs at some point in their lifetime. Many states have low-cost Part D plans that can save you money now (if you are not currently using any prescription drugs) and still act as a safety net in case your health situation changes.

Additionally, if you choose not to enroll in Part D when you first become eligible at age 65, you may face a lifelong financial penalty if you decide to sign up later. Learn more about Part D penalties you might face if you enroll late.

For access to free professional advice (from NCOA’s trusted partners) on finding the best Medicare plan for your needs, take the Medicare Questionnaire.

Can you delay enrollment in Part D and keep your current drug coverage?

Already have prescription drug coverage through your employer? You may be able to delay enrollment in Part D without incurring penalties—and keep your current prescription drug plan until you retire and/or lose your coverage—if you have what’s known as “creditable” drug coverage. This occurs when your current drug plan is considered “as good as or better than” Medicare Part D.

Check with your employer regarding your ability to delay enrollment in a Part D plan. Your insurance plan should also send you a letter telling you whether or not the company’s coverage is “creditable.” In general, if you have drug coverage through your job or your spouse’s job OR through the Veteran’s Administration and it is considered creditable, you can delay enrollment in Part D.

For more information on delaying your Part D enrollment, check out our “65 and still working” guide.

Can you enroll in Part C/Medicare Advantage instead of Part D to get drug coverage?

Yes. Medicare Advantage plans are private health plans that have contracts with Medicare. When you join one, you get your Medicare-covered healthcare services through the private plan.

Medicare Advantage plans must cover all the same things as Medicare Parts A and B. They may also cover prescription drugs. If you enroll in a Part C plan that covers drugs, you will use that plan for your drug coverage, rather than enrolling in Part D. For more information on Part C, check out our Part C guide.