When Can I Join or Switch to a Medicare Part D Prescription Drug Plan?

A fellow caregiver asked...

When can I join or switch to a Medicare Part D prescription drug plan?

Expert Answer

You can join a Medicare Part D prescription drug plan as soon as you first become eligible for Medicare Part A or enroll in Medicare Part B (either when you turn 65 or become eligible for Medicare because of a two-year, continuing period of Social Security disability benefits). Keep in mind that anyone eligible for Medicare Part A (whether enrolled or not) or actually enrolled in Medicare Part B is eligible to join a Medicare Part D prescription drug plan. If a Medicare Part D plan is offered in the region where you live, you can join the drug plan regardless of your health history.

If you're already enrolled in a Medicare Part D prescription drug plan but would like to switch to a different Part D plan, you can switch only during a six-week enrollment period: November 15 through December 31 of each year. However, if you receive Medicaid (Medi-Cal in California) coverage as well as Medicare, you can switch Medicare Part D drug plans at any time. You can also switch Part D plans at any time if you're a resident of a long-term care facility, such as a nursing home or board-and-care home.

Keep in mind that if you don't join a Medicare Part D prescription drug plan when you're first eligible, you'll pay a penalty if and when you eventually do join a Part D plan. (The purpose of this penalty is to encourage as many people as possible to sign up for Part D plans, thereby keeping down overall program costs.) The penalty does not apply if you have other "creditable prescription drug coverage", such as employer-sponsored health insurance, a Medicare Part C Medicare Advantage plan, or coverage through the V.A., TRICARE, or the Federal Employee Health Benefits program (FEHB). If you have such coverage but drop it or lose it, the Medicare Part D penalty provision will then begin to apply.

The penalty is a 1 percent rise in your premiums, on any Part D plan you eventually join, for every month you delay after first becoming eligible to join a Part D drug prescription plan.