How to Enroll in a Medicare Prescription Drug Plan
Key takeaways:
There are a few ways to sign up for Medicare Part D or a Medicare Advantage plan. You need to have Medicare in order to enroll in either.
Sign up during specified enrollment periods to avoid financial penalties.
When you’re ready to enroll in Part D or a Medicare Advantage plan, you can use Medicare’s Plan Finder to locate and compare plans in your area. Your costs will depend on your premiums, deductibles, copayment, and coinsurance.
Table of contents
If you’ve decided to get prescription medication coverage through Medicare, reviewed your options, and chosen a plan, then the next step is to enroll. As you’ll see, it’s not as complicated as it seems.
You must have Medicare before you enroll in Part D or a Medicare Advantage plan.
First, know that enrolling when you’re eligible is important because Medicare may charge you penalties if you don’t sign up during a specified window of time. Secondly, there are several ways to enroll, so you can choose whichever works best for you.
Prescription Savings Are Just the Beginning
See what other benefits you qualify for—from cashback cards to cheaper insurance.
If you need more information on Medicare prescription medication plans before making a decision, you can compare plans to determine how you can save.
How do you apply for a prescription drug plan?
When you’re ready to enroll in Part D or a Medicare Advantage plan, you can use Medicare’s Plan Finder to locate and compare plans in your area. Using the tool, you can enter your prescription medication information and estimate what your costs will be in the coming year.
Then, to sign up, you have a few options. You can:
Enroll through the Finder.
Complete an enrollment form for the plan you select.
Call the plan administrator directly.
Call Medicare at 1-800-MEDICARE (1-800-633-4227).
Remember that once you select a plan, it isn’t set in stone. You can re-evaluate each year and make changes during Medicare open enrollment, which is October 15 to December 7. If you’re on a Medicare Advantage plan, you can also switch to another Medicare Advantage plan from January 1 to March 31.
When do I enroll?
The best time to enroll in Medicare prescription medication plans and avoid potential penalties is during specific time periods. These are:
Initial Medicare enrollment period: Three months before the month you turn 65 years old, during your birthday month, and 3 months after your birthday month
Medicare open enrollment period: After you turn 65, during the open enrollment period (from October 15 to December 7)
Medicare Advantage open enrollment period: If you’re enrolled in a Medicare Advantage plan and want to switch to a different Medicare Advantage plan (or switch to original Medicare and join a separate Medicare prescription drug plan), during the Medicare Advantage open enrollment period from January 1 to March 31
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It’s important to be aware of a possible penalty for waiting too long to enroll or enrolling outside of these time periods. This penalty will be added to your plan’s monthly premium. You could end up paying it for as long as you’re enrolled in a Medicare prescription medication plan.
You can avoid the penalty by:
Enrolling during the initial enrollment period
Not going 63 days or more in a row after your initial enrollment period without Medicare prescription drug coverage or creditable drug coverage (coverage that pays, on average, at least as much as Medicare’s standard coverage)
Keep in mind that you can only be enrolled in one type of prescription medication plan. If you are already enrolled in a Medicare Advantage plan that includes prescription medication coverage and you enroll in Part D, for example, Medicare will disenroll you from the Medicare Advantage plan and place you in original Medicare.
What does Medicare Part D cover?
Medicare Part D can help you pay for your brand-name or generic prescription medications. All plans cover the same categories of medications, but each plan will cover specific medications within those categories, which are known as tiers.
For example, Tier 1 includes medications that are usually generic and have the lowest copay. Tier 3 medications include generics, preferred brands, and non-preferred brands. If you take a particular medication, make sure that the plan you choose will cover it by checking its formulary list.
How much does a Medicare drug plan usually cost?
Various costs are involved in Medicare Part D coverage, as well as the specific medications you need. The total costs associated with each specific drug plan in 2024 may include:
The average monthly premium of $55.50
An annual deductible of up to $545
Copayments or coinsurance up to 25% (coverage gap) of the prescription medication cost after you and your plan spend an initial coverage limit of $5,030 until your out-of-pocket expenses are $8,000 (catastrophic phase)
If you need financial assistance to pay for your prescription drug plan, Medicare offers an Extra Help low-income subsidy program that can help you pay for expenses such as premiums, deductibles, and coinsurance.
How does GoodRx work with your Medicare prescription benefits?
You are allowed to use GoodRx discounts in lieu of, but not combined with, your Medicare Part D plan. You can compare prices for the medication you need on GoodRx.com. If using the GoodRx coupon will be the most cost-effective option, simply have the pharmacist process the transaction as cash instead of through Medicare or your own insurance.
Whom can I contact for help with Part D or Medicare Advantage enrollment?
If you need help with Part D enrollment or selecting a Medicare Advantage plan, you can contact your state’s health insurance assistance program. These programs offer counseling to help people understand their Medicare benefits and how to use them.
You can also use this checklist from the National Council on Aging that walks you through how to select a Medicare prescription medication plan.
The bottom line
There are a few ways to find and enroll in a Medicare Part D or Medicare Advantage plan. First, you’ll need to have Medicare.
Pay attention to the timing of when you sign up. Doing so outside of specific enrollment periods could put you at risk for permanent financial penalties.
Want to save more on prescriptions? You can use GoodRx to save money on prescription medications while on Medicare.
Why trust our experts?
References
Centers for Medicare & Medicaid Services. (n.d.). Catastrophic coverage.
Centers for Medicare & Medicaid Services. (n.d.). Costs in the coverage gap.
Centers for Medicare & Medicaid Services. (n.d.). How do I sign up for Medicare?
Centers for Medicare & Medicaid Services. (n.d.). When to join a Medicare health or drug plan.
Centers for Medicare & Medicaid Services. (n.d.). Part D late enrollment penalty.
Centers for Medicare & Medicaid Services. (2023). Medicare Advantage and Medicare prescription drug programs to remain stable in 2024.
National Council on Aging. (2021). Checklist to help you choose a Medicare Part D plan.
Medicare Rights: Medicare Interactive. (n.d.). Creditable drug coverage.
