How to get prescription drug coverage

Medicare drug coverage helps pay for prescription drugs you need. Even if you don’t take prescription drugs now, you should consider getting Medicare drug coverage. Medicare drug coverage is optional and is offered to everyone with Medicare. If you decide not to get it when you’re first eligible, and you don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, you’ll likely pay a late enrollment penalty if you join a plan later. Generally, you’ll pay this penalty for as long as you have Medicare drug coverage. To get Medicare drug coverage, you must join a Medicare-approved plan that offers drug coverage. Each plan can vary in cost and specific drugs covered.

There are 2 ways to get Medicare drug coverage:

1. Medicare drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. You must have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) to join a separate Medicare drug plan.

2. Medicare Advantage Plan (Part C) or other Medicare health plan with drug coverage. You get all of your Part A, Part B, and drug coverage, through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.

Visit Medicare.gov/plan-compare to get specific Medicare drug plan and Medicare Advantage Plan costs, and call the plans you’re interested in to get more details. For help comparing plan costs, contact your State Health Insurance Assistance Program (SHIP).

6 tips for choosing Medicare drug coverage

If you’re wondering how to choose a Medicare drug plan that works for you, the best way is to start by looking at your priorities. See if any of these apply to you:

  • I take specific drugs.
  • I want extra protection from high prescription drug costs.
  • I want my drug expenses to be balanced throughout the year.
  • I take a lot of generic prescriptions.
  • I don’t have many drug costs now, but I want coverage for peace of mind and to avoid future penalties.
  • I like the extra benefits and lower costs available by getting my health care and prescription drug coverage from one plan, and I’m willing to pick a drug plan with restrictions on what doctors, hospitals, and other health care providers I can use.

Now that you have some information for how to choose a Medicare drug plan, you may want to learn more about Medigap and Medicare drug coverage.

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If you feel like you have been spinning your wheels wondering how to make the best decision when it comes to your Medicare plan, you are in the right place. The good news is, you don’t have to do this alone. We are in the business of helping people understand Medicare, in simple, plain terms that everyone can understand. We believe it’s important that your first understand Medicare itself. You can’t understand your Medicare options until you first understand basic Medicare benefits. Fortunately, we’ve mastered how to make it simple.

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