Option 1: Enroll in a Medicare prescription drug plan
When can I join a Medicare Part D prescription drug plan?
You can enroll in Medicare Part D during the seven-month period surrounding your 65th birthday. The seven months consists of the three months before the month of your birthday, the month of your birthday, and the three months after your birthday. This time frame is called your Initial Enrollment Period for Part D (IEP for Part D).
Example: Jane Smith's 65th birthday is May 27. She is eligible for Medicare Part A, and her Parts B and D initial enrollment period begins on February 1 and ends August 31 of the year she turns 65.
If you did not enroll in a Medicare Part D plan during your birthday year, you can enroll during the open enrollment period, November 15-December 31 of each year.
Medicare drug plan designs
Medicare drug plans have various levels of cost for deductibles and premiums.
Almost all Medicare drug plans are set up as three-tier plans. The amount you pay will be based on whether your drug is a generic, a preferred brand, a non-preferred brand, or a biological (specialty) drug.
Many plans offer a mail order option; some even offer a three-month supply of drugs for only two copayments. Over a year, you pay only eight copayments instead of 12. This can save you money, especially if you have many prescriptions.
Medicare does not require Medicare drug plans to include a standard list of covered or preferred drugs. Therefore, you should not sign up for any plan without first checking to ensure that your drugs are covered by that plan. You should also check to see on which tier your drugs are covered. Your copayments will vary significantly by tier. You may want to discuss your medications with your doctor(s) to see if there are generics or other alternatives (such as tablet splitting) that can safely help you reduce your costs.
How to choose a plan
Here are a few guidelines to follow when choosing a Medicare drug plan:
- Check the resources listed on this page. The Medicare Web site includes the Medicare Drug Finder that will allow you to enter your drugs and obtain a report about how various drug plans will cover your prescriptions. If you're not comfortable using a computer, you may contact 1-800-MEDICARE or your county's Benefit Specialist to obtain the top 3 Part D plans for your specific medications.
- Call a few companies and check to see if and at what copayment levels your drugs are covered. If your drugs are not covered or are covered at the third tier, check another plan.
- If you are willing to use mail order, pick a plan that charges less than three copayments for a three-month supply.
- Check to see if your pharmacy is in the company’s network.
- If you are worried about picking the perfect plan, remember that Medicare gives you the opportunity to change plans each year.
- You can also call the Trust's Customer Service Department at (800) 279-4000 for further assistance.
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