Medicare drug coverage helps pay for prescription drugs your client needs. Even if they don’t take prescription drugs now, they should consider getting Medicare drug coverage. Medicare drug coverage is optional and is offered to everyone with Medicare.
If your client decides not to get it when they're first eligible, and don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get LIS (Extra Help), they'll likely pay a late enrollment penalty if they join a plan later. Generally, they'll pay this penalty for as long as they have Medicare drug coverage. To access our Late Enrollment Calculator, click here.
There are 2 ways to get Medicare drug coverage:
- Medicare drug plans, also known as PDP's. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. Your client must have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) to join a separate Medicare drug plan.
- Medicare Advantage Plan (Part C) or other Medicare health plan with drug coverage. Your client will get all of their Part A, Part B, and drug coverage through these plans. Remember, your client must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.
Does Part D work with all other insurance coverage?
Short answer, no. Part D does not work with all other insurance coverage and may in fact interfere with or even cancel your client's current coverage. It's important to know the laws on How Part D works with other insurance.
VA Health benefits and Part D
Remembering all the rules for Medicare and Veterans benefits can be confusing. Use the following sites as guides to be sure you are bettering your client's situation, and not hurting.
- VA Benefits and Health Care
- TRICARE vs. TRICARE For Life
- CHAMPVA and CHAMPVA Fact Sheet
- Your Guide to Medicare Prescription Drug Coverage
The 4 Phases of Part D Coverage Explained
- Phase 1: Deductible Period
- Phase 2: Initial Coverage Period
- Phase 3: Coverage Gap (AKA., the donut hole)
- Phase 4: Catastrophic Coverage
