Part D Plans

I want to preface everything we cover with this caveat: Drug plans change. They can change every year, and formularies within any year. Only a few aspects are fixed. Formularies change, pricing changes, premiums change, to name a few.

When you enroll in Medicare A and B, the Medicare rules say you have the option enroll in a Part D plan, but it’s not mandatory. You can do so by enrolling in a Medicare Advantage Plan with Part D, MAPD. Or if you have Original Medicare or Original Medicare with a Medigap plan, you can enroll in a standalone Part D plan. 

But what if you don’t want to sign up for a drug plan? You don’t have to. But there is a catch. Let’s say you don’t take meds and don’t want drug coverage. That’s your choice. Two years pass and your health changes. You need some medications and some are expensive. You learn that a Part D plan will save you substantially. You can’t just enroll in a plan at any time. You have to wait until Annual Enrollment- October 15 through December 7. And your plan will start in January. But there’s more.  Medicare will assess you with a fine. For every month you were not in a Part D plan after your Medicare started, you will be fined 1% of the National Average premium cost for Part D plans. Right now in 2021, it’s around .33 a month. If it was 24 months, you will pay approximately 7.92 every month for the rest of your life. Now, .33 may not be exact but it will within a couple pennies. There is an exception to paying that fine. If your income qualifies you for a Low-Income Subsidy you avoid the fines.

Give the fines and enrollment restrictions some thought before you say no to Part D coverage.

When we meet with new clients, we check to see which plan is best for their current medications. There could be substantial cost differences between one plan and another. We use Medicare.gov to do the analysis. Later I will do a video showing how to use Medicare.gov to find drug costs. Sometimes one Med Advantage plan will be hundreds more or less than another. Stand alone plans can also vary.

The video will help navigate the maze of Part D drug coverage.