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

4 answers | Last updated: Oct 31, 2016
A fellow caregiver asked...

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

Expert Answers

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.

Community Answers

Helpful hint answered...

I like many find Medicare very confusing. The only tip I can offer is that you should contact www.simplefill.com when you are approching the donut hole.

You might want to call them and ask explain your situation regardless of being in the donut hole as well because sometimes they have ideas of better ways to save money. Their number is 1-877-420-6496 and the company is SimpleFill. Good luck!

A fellow caregiver answered...

But I was told by Medicare that I couldn't sign up for Part D until the next open enrollment period in November. (I signed up for A and B last November, but not D, and now want D as well.) So I'm confused. They didn't say anything about an accrusing monthly penalty for every month I delay. I'm in California and have no other drug coverage.

Bellamia answered...

Extend Health has a great site where you can find out if you qualify for Medicare[extendhealth.com] coverage, determine coverage availability in your area, and enroll in the plan that best fits your needs. https://www.extendhealth.com