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Medicare Part D Prescription Drug Plans.
Medicare Part D, the prescription drug benefit, is the part of Medicare that covers most outpatient prescription drugs. Part D is offered through private companies either as a stand-alone plan, for those enrolled in Original Medicare, or as a set of benefits included with your Medicare Advantage Plan.
Unless you have creditable drug coverage and will have a Special Enrollment Period, you should enroll in Part D when you first get Medicare. If you delay enrollment, you may face gaps in coverage and enrollment penalties.
Each Part D plan has a list of covered drugs, called its formulary. If your drug is not on the formulary, you may have to request an exception, pay out of pocket, or file an appeal.
A drug category is a group of drugs that treat the same symptoms or have similar effects on the body. All Part D plans must include at least two drugs from most categories and must cover all drugs available in the following categories:
You purchase Part D in addition to Parts A and/or B.
You have two choices:
1) Stand-alone Medicare Prescription Drug Plan (PDP).
2) A Medicare Advantage Plan that comes with prescription drug (Part D) coverage.
Medicare Part D Enrollment Time-frame
Initial Enrollment Period (IEP) is when you are newly eligible for Medicare because you are turning 65. You may enroll during the 7-month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.
Annual Enrollment period (AEP) begins October 15 and ends December 7 of each year. During this period you may switch Medicare Advantage Plans, including one that does offer drug coverage to a Medicare Advantage Plan that does not offer drug coverage. During this period, you may join a Medicare Prescription Drug Plan, switch from one Medicare Prescription drug Plan to another Medicare Prescription Drug Plan, or drop your Medicare Prescription drug coverage completely.
Special Enrollment Period (SEP) is for special circumstances such as, losing your employer coverage, moving to a new service area, or if you are receiving government monetary assistance.