the medicare drug plan
6 Key Facts

1. Anyone on Medicare can get coverage regardless of income or health.

2. You are not obligated to enroll, but there may be consequences if you don't sign up when you are first eligible to do so.

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

4. 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.

5. 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.

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

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Medicare Prescription Drug Coverage Guide

Part 1: How Medicare Part D Works

Understanding the basics

by: Patricia Barry | from: AARP Bulletin | Updated January 2011

Medicare Part D Guide

— Tetra Images/Corbis

   1. How Part D Coverage Works
   2. Extra Help Paying for Drugs
   3. The Doughnut Hole
   4. Do You Need Part D?
   5. Choosing a Part D Drug Plan
   6. Enrolling in Medicare Part D
   7. Glossary of Terms
   8. Where to Go for Help
   9. Use the Medicare Plan Finder

Medicare Part D (main page) Go

Before deciding whether to sign up for Medicare drug coverage, you need to understand how the program works together as a whole. Grasping the big picture makes it easier to deal with the details.

Who can get Medicare drug coverage?

Anyone on Medicare (with either Part A or Part B) is entitled to drug coverage (known as Part D) regardless of income. No physical exams are required. You cannot be denied for health reasons or because you already use a lot of prescription drugs.

Do I have to sign up?

For most people, joining Part D is voluntary. However, if you now get your drugs from Medicaid, you must get them from a Medicare drug plan as soon as you become eligible for Medicare.

You won’t need to sign up if you have other drug coverage that is better than Medicare’s—for example, benefits from a current or former employer or union. (See Do You Need Medicare Part D?)

But if you don’t have other drug coverage that’s considered as good as Medicare, and you delay signing up, you’ll incur a late penalty that adds to your premiums for as long as you’re in the program, except in certain circumstances, and you’ll be able to enroll only during open enrollment at the end of the year.