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  3. Medicare Prescription Drug Benefit (Part D)

Medicare Prescription Drug Benefit (Part D)

Is there coverage for prescription drugs under Medicare?

In 2006 Medicare added a prescription drug benefit called Medicare Part D. Medicare contracts with private companies to offer prescription drug plans. You can enroll in a plan that offers only drug coverage or you can enroll in a Medicare Advantage plan which includes drug coverage, along with other health coverage.

There are many plans to choose from. Generally you must stay in the plan you choose for a calendar year (there are some exceptions). Every year from October 15 to December 7 there is an annual election period when you can change plans, drop coverage or add coverage. The plans can change premiums, co-payments and formularies (list of drugs they cover) every year so reviewing plans during the election period is important. The best way to compare plans is to use the Medicare website or SHIIP--SMP counselors can also help you compare plans.

You may have “creditable drug coverage” through an employer, union or other plan. If it is creditable (as good as, or better than Medicare’s coverage) you do not need a Medicare Part D plan.  For more information about Medicare Prescription Drug Coverage see SHIIP's factsheet Medicare Prescription Drug Coverage.

If you have limited income and resources you might be eligible for help with your prescription drug costs and co-payments for Medicare and Part D drug costs. Read our Additional Help flyer to see if you qualify.