How To Apply For Medicare Part D
Medicare Part D plans are provided privately, and there are a few different ways that you can sign up for a plan. You are eligible for Part D once you are eligible for Medicare. You can opt to either purchase a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage.
How Can You Get Part D Coverage?
If you are looking to get Part D coverage, the first thing you should do is compare your options. The two routes you can take are to either purchase a stand-alone drug plan or switch over to Medicare Advantage.
If you already have and are happy with Original Medicare, then you may want to look into stand-alone plans. These private plans handle just your drug coverage and come with a separate premium, so it is essentially separate from the rest of your health care.
Make sure to compare the formularies of different stand-alone plans to ensure that your specific medications are covered.
Your other option is to switch over to Medicare Advantage. Also known as Part C, these plans are available through private insurers but replace Original Medicare to handle all of your health care.
Medicare Advantage plans have to include at minimum everything that is covered under Original Medicare, but typically include additional benefits and expanded coverage as well. This often includes prescription drug coverage.
How Do You Sign Up for Part D Coverage?
If you’re looking to sign up for Medicare Part D, you can use the Medicare plan finder to locate and compare what’s available in your area. Be sure to look into different comparison points, like the premium for each plan and their respective formularies.
According to AARP, you can enroll in plans directly from the plan finder after you provide some information. But it is always wise to do research and possibly talk to an expert before enrolling in a plan to ensure that you have selected the best option available.
You can also enroll in plans directly through the private insurance companies that offer them, sometimes by calling them or visiting their websites. You can also call Medicare at 800-MEDICARE (800-633-4227).
Information You Need to Provide
You will need to provide your basic information to enroll in a Part D plan. You’ll also need to give the information that is on your Medicare card, like your Medicare number and when your coverage began.
When searching for a plan or asking questions about your options, you may also want to have ready information on the medications you need covered and how much you are willing to pay in premiums or copayments.
When Are the Part D Enrollment Periods?
When you become eligible for Medicare, you are also eligible for Part D. There are several different points throughout a calendar year when you can enroll in a new plan.
Initial Enrollment Period
Your initial enrollment period is your first chance to enroll in a Part D plan. This period begins three months before the month of your 65th birthday and ends three months after, creating a seven-month window for you to enroll.
If you don’t sign up during this period, you may end up having to pay a penalty if you choose to do so later.
Special Enrollment Period
You may also be eligible for a special enrollment period. This is triggered by certain life events related to your health care, like if you unexpectedly lose your coverage, or if you move and your current plan doesn’t service your new area.
Annual Enrollment Period
After your initial enrollment period, there will also be an annual enrollment period each year where you can make changes to your existing coverage or sign up for Part D if you didn’t during your initial enrollment period.
The open enrollment period runs from Oct. 15 to Dec. 7 each year. Additionally, there is a second annual enrollment period for beneficiaries who have Medicare Advantage, which is from Jan. 1 to March 31.
How Do You Know if Your Application Was Accepted?
Since Part D plans are provided by private insurers and not the federal government, there is no standardized way to check the status of your application or whether or not it was accepted.
You will likely need to reach out to the private insurance company you have purchased the plan through to check your status as an applicant.
The plan provider should notify you once your application has been approved. If time has passed and you haven’t received an update, then you should reach out to the insurance company by calling them or checking their website.
When Will Your Part D Coverage Begin?
When your Part D coverage begins depends on which enrollment period you sign up during and can somewhat vary. If you sign up for Medicare Advantage that includes drug coverage or a stand-alone Part D plan during your initial enrollment period, then your coverage will generally begin based on when in the enrollment period you signed up.
If you enrolled in the three months before your 65th birthday, then coverage should start the month you turn 65. If you sign up the month of your birthday, coverage should begin the month after. If you sign up within the three months after your birthday, it may take up to a few months for your coverage to begin.
If you enrolled during the open enrollment period, your coverage will typically begin at the start of the new year.
Coverage typically starts the month after you sign up if you enroll during a special enrollment period.
3 Cited Research Articles
- Lankford, K. (2022, January 28). Use Medicare’s Plan Finder to Choose, Enroll in Part D. Retrieved from https://www.aarp.org/health/medicare-insurance/info-2022/part-d-enrollment.html
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Find a Medicare plan. Retrieved from https://www.medicare.gov/plan-compare/#/?lang=en&year=2022
- U.S. Centers for Medicare & Medicaid Services. (n.d.). How to get prescription drug coverage. Retrieved from https://www.medicare.gov/drug-coverage-part-d/how-to-get-prescription-drug-coverage