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Do I have to reenroll in my Medicare Part D prescription drug plan every year?

En español | No. If you like your current Part D drug plan, you can keep it without doing anything additional. You don’t have to reenroll or inform the plan that you’re staying.

But reviewing your present plan during Medicare’s annual open enrollment period Oct. 15 to Dec. 7 is always a good idea. All Part D plans can change their costs and coverage every calendar year, and you may need to take different medications from year to year, too.

The plan that works best for you now won’t necessarily be your best deal starting Jan. 1 of next year. So it’s important to consider your options every year.

How to figure out what will change next year 

The first step: Carefully read a letter you’ll receive from your plan in September, called the annual notice of change. Medicare requires all plans to send this notice to enrollees every year informing them of any changes the plan will make for the next year. That includes four areas:

  1. Costs, meaning premiums, deductibles, copays
  2. Benefits, which drugs are covered
  3. Service area, if a plan has changed its geographical reach, and
  4. Pharmacies in the plan’s network

If you don’t receive this annual notice of change, ask your plan for the information. 

The second step: Pay special attention to whether the medications you’re taking now or expect to take in the new year will still be covered and at what cost to you. Don’t take this step for granted even if the prescriptions you’re taking are generic.

The details of this letter will tell you about changes in the new year to your Part D plan’s formulary, its list of covered drugs, and whether those drugs are moving to a different tier, which are drugs grouped together based on the price you’ll pay. Insurers often charge lower copayments for preferred generic and preferred brand-name drugs than they do for medications not on their preferred lists.

Each private insurer that offers Part D plans negotiates with pharmaceutical companies on the prices they will have to pay. The insurers update the medicines in their formulary tiers in the annual notice of change letter.  

The third step: Reviewing your annual notice of change gives you a basis to compare your current plan with others offered in your area. You may be particularly interested in looking into other plans during open enrollment if some of your favorite features of your current plan will be changing.

How to compare Part D plans during open enrollment

Even if your plan isn’t making big changes, comparing all your options during open enrollment is a good idea. In addition to the changes in your needs, other plans may enter your area or change the costs and coverage that you saw when you first compared plans.

Comparing all your options using Medicare’s Plan Finder is easy. Type in your zip code and your drugs and dosages to see the total costs you would pay with each Part D plan in your area — premiums as well as copayments for your medications. A plan with low premiums may end up costing you more if it charges high copayments for your prescriptions.

You’ll be able to find out whether a plan has preferred pharmacies with lower copayments. Also find out if the plan has any special restrictions on your medications, such as whether your doctor has to complete prior authorization forms before the drug will be covered or if you need to try a lower-cost drug first before the plan will cover a similar but more expensive medication. That’s called step therapy.

You can also call 800-MEDICARE (800-633-4227) to get help choosing a plan, or you can work with your State Health Insurance Assistance Program (SHIP).

How to switch to a different Part D plan

If you discover that a different Part D plan will be better for you in the coming year, you can sign up for the new plan online through the Medicare Plan Finder, call Medicare or call the plan to enroll. You do not have to inform your current plan that you are making the change.

Signing up with a new plan automatically cancels your coverage from the old one on the specified date. If you sign up for a new plan during open enrollment, your new coverage will take effect Jan. 1. 

You can switch plans during other times if you qualify for a special enrollment period, such as moving out of your present plan’s service area.

Keep in mind

You can qualify for financial assistance with Part D premiums and copayments through Medicare’s Extra Help program if you have low income and assets. If you qualify for Extra Help, you can change Part D plans as often as once each calendar quarter. 

If you haven’t selected a Part D plan and you’re approved for Extra Help, the Centers for Medicare & Medicaid Services will send a letter telling you which plan you have been enrolled in and how to change plans. But it’s better for you to look at all the plans in your area to compare costs and coverage for your medications and choose the one with the best coverage for you.

Updated May 19, 2022

     

        


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