If you don’t have other drug coverage that’s considered “creditable,” meaning at least as good as Part D, the answer is yes.
Unless you have creditable coverage from another source — such as prescription coverage from an employer, former employer, Tricare, the Department of Veterans Affairs or another source — you may have to pay a late enrollment penalty if you decide to sign up for Part D later.
Medicare calculates the penalty as 1 percent of the national average Part D premium for every month you delayed, and it can add up quickly. The monthly penalty lasts for as long as you have Part D coverage and increases every year the national average premium goes up.
Consider Part D a safety net
Another concern with skipping Part D: You don’t know when you might need to take an expensive prescription medication. Some medicines cost thousands of dollars a month.
That’s because you can sign up for a Part D plan only at certain times. Those times include when you first enroll in Medicare or during the annual open enrollment period from Oct. 15 to Dec. 7, with coverage starting Jan. 1.
If you don’t have Part D in place and you develop a medical condition that requires expensive drugs, you may have to pay the full price. And worse, you’ll still be accumulating penalties that will be payable when you do decide to enroll in a Part D plan.
How to choose a plan if you take few medications
Whether you’re on a few medicines or none, paying monthly premiums for a Part D plan may seem like a waste of money. Instead, consider a compromise. Pick a Part D plan with the lowest premiums in your area.
That could mean paying about $7 a month, according to a Kaiser Family Foundation study of 2022 plans. That way, you get some protection at the lowest cost and avoid a penalty whether you have prescriptions or not.
But even if you take one pill a day, check the inexpensive plans to make sure that your medicine is covered and at what price. A plan with the lowest premiums may not be the least expensive overall if it has high cost sharing for your medicine.
If a doctor prescribes expensive medications during the year, you can switch Part D plans during open enrollment. You can compare total costs for each plan in your area — including premiums and copayments for your specific medications — by using the Medicare Plan Finder.
Keep in mind
If you have low income and assets, you may be eligible for Extra Help. This federal program can help pay Part D premiums, deductibles and cost sharing while allowing you to enroll in a plan without penalty.
Updated May 12, 2022