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Understanding Your Prescription Drug Coverage

En español l Medicare has an optional program — called Medicare Part D — that provides insurance to help you pay for prescription drugs. If you select to have the coverage, you pay a monthly premium. This guide explains how the program works and helps you make decisions in choosing a plan that's right for you.

 

The Medicare Drug Plan: 6 Key Facts

Anyone who has Medicare Part A or Part B (or both) can get Part D coverage regardless of income or health.

 

You are not obligated to enroll, but there may be consequences (such as permanent late penalties and delayed coverage) if you don't sign up when you are first eligible to do so.

 

To get Medicare drug coverage, you must select one approved private drug plan among many offering different choices. There is no single government plan.

 

Is your income limited? If you qualify for a part of the program known as "Extra Help." you'll pay very little for your medications.

 

Are your drug costs very high? You'll pay no more than 5 percent of the cost of each prescription after you've spent a certain amount of money out-of-pocket in any one year.

 

Do you have better drug coverage already? You probably won't need Medicare's Part D coverage. But it's wise to check.

 

Your Medicare Part D Questions Answered

Part 1: How Medicare Part D Works

Before deciding whether to sign up for Medicare drug coverage, you need to understand how the program works as a whole.

Part 2: 'Extra Help' Paying for Prescriptions

If you have a limited income you may qualify for Medicare's "Extra Help" coverage.

Part 3: Moving In and Out of the Doughnut Hole

Medicare Part D provides coverage up to a certain level each year. After that, there's a gap known as the "doughnut hole."

Part 4: Do You Need Medicare Part D?

Don’t dismiss Medicare drug benefits out of hand — even if you have good coverage or don’t take any prescription drugs

Part 5: Choosing a Part D Drug Plan

Compare what's available to find the plan that's best for you.

Part 6: Signing Up for a Part D Drug Plan

Once you’ve chosen a Part D plan, it’s easy to sign up. But make sure the plan you're buying really is the plan you want.

Additional Resources

Ask Ms. Medicare

If you can't find the Part D answer you're looking for in this guide, ask Ms. Medicare by emailing your query to msmed@aarp.org. Be sure to include your name, age, state and ZIP code. Your name will not be published.

Medicare Part D Glossary

Defining Part D's words, phrases and jargon.

Where to Go for Help 

Sources of information and assistance.