Are Medicare Part D Plans Necessary? For Many, the Answer Is Yes

Healthcare Writer

Updated on June 20th, 2024

Reviewed by Diane Omdahl

We aim to help you make informed healthcare decisions. While this post may contain links to lead generation forms, this won’t influence our writing. We follow strict editorial standards to give you the most accurate and unbiased information.

Unlike Original Medicare, which has existed since the 1960s, you didn’t grow up with Medicare prescription drug plans. These plans – also known as Medicare Part D – have only been around since 2006. Naturally, you may still have questions, like “do I need Medicare Part D?”

Medicare Part D prescription drug coverage is optional. In spite of this, most Medicare beneficiaries – particularly those with chronic conditions – will still want to get Medicare Part D coverage.

What Are Medicare Part D Prescription Drug Plans?

Medicare Part D plans are a specific type of private, government-regulated prescription drug coverage that works with your Medicare insurance. You’re eligible to enroll in a Part D plan if you receive Medicare upon turning 65. You’re also able to enroll if you sign up for Medicare due to a disability. If you delay getting Part D coverage for a while because you already had a group health plan that covered prescription drugs, you can apply for Part D when your existing coverage ends.

Considering a Medicare Part D Plan?

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Most people will need Medicare Part D prescription drug coverage. Even if you’re fortunate enough to be in good health now, you may need significant prescription drugs in the future. A relatively small Part D payment entitles you to outsized benefits once you need them, just like with a car or home insurance.

You could rely on charity care or alternate drug plans, but they come without the stability and consumer protections of federally-regulated Medicare Part D plans. Government programs also provide help with Part D payments for Medicare beneficiaries with limited means.

There are a few circumstances where it doesn’t make sense to get Medicare Part D:

  • If you have a Medicare Advantage policy, it may already include Part D prescription drug coverage (also called a MA-PD plan). You won’t need to look for a separate plan.
  • If you have creditable coverage – equivalent prescription drug coverage like that from a large employer, TRICARE, PACE, or the VA – then you may not need Medicare Part D. You can postpone Medicare Part D enrollment without penalty for as long as you maintain your creditable coverage.
  • If you’re in the end stages of a life-threatening disease and under Medicare hospice care, Medicare Part A covers medications related to the terminal condition. If you need medications for anything not related to that condition, you will need to purchase Part D coverage.

Premiums: Similarly to Medicare Part B, you’ll pay an additional adjustment to your monthly Part D premium if you listed high income on your tax returns two years ago, have substantial investments, or a sizable pension. However, delaying Part D because you must pay the higher-income beneficiary adjustments can expose you to a lifelong penalty.

Considering a Medicare Part D Plan?

Review options now.

Considering a Medicare Part D Plan?

Review options now.

Cases for Medicare Part D Plan Prescription Drug Coverage

Average Beneficiary

Common chronic conditions such as multiple sclerosis, cardiovascular diseases, and respiratory illnesses have high drug costs that make having Part D a huge relief. If you have multiple chronic conditions (which apply to seven out of 10 Medicare beneficiaries), it’s probably a good idea to get Medicare Part D drug coverage.

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