An Overview of the Medicare Part D Prescription Drug Benefit

An Overview of the Medicare Part D Prescription Drug Benefit| HealthSoul

What Is the Medicare Part D Program?

The Medicare Part D program is a voluntary prescription drug coverage program offered as an extension of Medicare coverage. Most seniors already have Medicare coverage, but Part D is an extra program that covers prescription medications. Part D plans work much the same as any other health insurance plan, with a few key differences:

  • Seniors who enroll in the program must pay a monthly premium for the coverage. Depending on which plan you choose, you may have to pay different amounts for your monthly premium.
  • Unlike traditional health insurance, you do not have to wait until you get sick before you can start using the coverage. You can use the plan to help pay for your medications as soon as you join the program.
  • You won’t be reimbursed when you use the coverage. Instead, the plan operates like a discount program. When you fill your prescription, the insurance company will pay the pharmacy less than they charge you.

Who Is Eligible for the Medicare Part D Plan?

Not all seniors are eligible for the Medicare Part D plan. Seniors must enroll in Medicare Parts A and B to qualify for it. If you have a medical condition that prevents you from getting standard health and life insurance policies, you may not be able to get a Part D policy either. The insurance companies that provide the Part D plans are responsible for screening applicants for pre-existing conditions. If you have a condition preventing you from obtaining standard health insurance, you will not be approved for a Part D plan. However, if you currently have insurance and are concerned about maintaining your coverage as you age, you may want to consider enrolling in Part D coverage now. You can enroll in the program anytime, but you must sign up during your initial enrollment period.

How Much Does the Part D Plan Cost?

The cost of the Medicare Part D plan varies depending on which plan you choose. Depending on the coverage offered and your health status plans range in cost from $0 to $80 per month. In general, the more comprehensive the plan, the higher the premium. You can only expect to pay a monthly premium if you enroll in the standalone Prescription Drug Plan. If you choose the Medigap plan, you will pay a one-time annuity at enrollment. As for the medication costs, Medicare only covers certain types of prescription drugs. The coverage for these drugs is very good, but other medications do not have coverage. If you take a medication that is not covered, you will have to pay for it out-of-pocket. Remember that you will pay less for these drugs if enrolled in a Part D plan because of the discount you receive. You can use the price comparison tool on to estimate your costs based on your situation.

Who Offers the Part D Plan?

The insurance companies that participate in the Medicare Part D program are the same companies that offer other types of health insurance plans. The Part D plans are the same as other types of policies offered by the same companies. This means that you will be able to choose from a variety of different plans with different coverage amounts and different premiums. If you are enrolled in Medicare Parts A and B, you will have the opportunity to sign up for a variety of different Part D plans. However, you cannot sign up for every single plan offered. There are limits to how many policies you can enroll in. If you are currently enrolled in a policy, you will only be able to sign up for a new plan if you drop the old one. If you are not currently enrolled in any policies, you will have the opportunity to enroll in any of the Part D plans offered by each insurance company. You must choose a plan during your initial enrollment period, the first ten months after you become eligible for Medicare.

Important Information about the Medicare Part D Plan

  1. How you select a plan– You can choose a plan online or over the phone once your initial enrollment period opens. You can also select the plan during your annual Medicare interview.
  2. How to change plans– You have the option to change plans once every 12 months. You can do this either online or during your annual enrollment period.
  3. How you pay for the plan– You must pay for the plan during your initial enrollment period. You will pay a lump sum, monthly, or a one-time annuity.
  4. How the plan works– Your Part D plan will pay for a portion of your medications, and you will pay the remainder. You will pay a co-pay for each medication that you take.
  5. When you can start using the plan– You can start using the plan as soon as you sign up. You will receive your first prescription drug coverage statement after one month.
  6. Who is not eligible for the plan– You are not eligible for the plan if you have health insurance other than Medicare. You must drop your other insurance before you can sign up for Medicare.


If you are a senior enrolled in Medicare Parts A and B, you should consider enrolling in a Medicare Part D plan. The plan will help you manage your prescription drug costs. There are many different plans available, so selecting one that is right for your needs is important. You can use this article as a guide when reviewing your options.