Medicare Part D is optional prescription drug coverage offered through private plans. It helps cover the cost of medications through premiums, deductibles, and formulary tiers.
Going without creditable prescription drug coverage for 63 days or more after you’re first eligible may result in a late enrollment penalty on your Part D premium. Enrolling when you first qualify—or keeping creditable coverage through an employer or other plan—helps you avoid it.
Your Initial Enrollment Period is the seven-month window around your 65th birthday—three months before, the month you turn 65, and three months after. It’s usually the first chance to enroll in Medicare Part D without a late enrollment penalty.
SEPs are limited windows outside the Annual Enrollment Period when you may enroll in or switch Part D coverage because of a qualifying event—such as moving out of your plan’s service area, losing creditable drug coverage, qualifying for
Extra Help, or entering or leaving a nursing home.
Yes, if you qualify for full Extra Help (LIS), Medicare pays your standalone Part D plan premium up to the benchmark amount for your area. You may still owe a small difference if you choose a plan priced above that benchmark, and copays for covered drugs are also reduced.
No. Medigap (Medicare supplement) plans do not include prescription drug coverage. For creditable Part D coverage, you typically need a standalone Part D plan, a Medicare Advantage plan that includes drugs, or other creditable coverage—such as through an employer or union plan.
How can I avoid the Part D late enrollment penalty?
What is the Initial Enrollment Period?
What are Special Enrollment Periods (SEPs)?
Does LIS cover standalone PDP premiums?
Do Medicare supplements include creditable Part D coverage?