Medicare Part D is the part of Medicare that is a prescription drug benefit. It is not part of Original Medicare. Original Medicare doesn’t cover most of your medications (except those you may receive as a hospital inpatient or, in some cases, outpatient).

Medicare Part D is an optional United States federal government program to help Medicare recipients pay for self-administered prescription drugs through prescription drug insurance premiums. Medicare Part B covers all the costs of almost all professionally administered prescriptions and certain prescription drugs that you get in an outpatient setting, like a doctor’s office. However, these tend to be the kind of medications that you need a doctor to give you, like infusion drugs. The newest addition to Medicare, Part D was originally proposed by President Clinton in 2000 and enacted as part of the Medicare Modernization Act of 2003.

If you want help with most other medication costs, you’ll need to sign up for Medicare Part D coverage.

Who is eligible for Medicare Part D?

  • Individuals on Medicare are eligible for prescription drug coverage under a Part D plan if they are signed up for benefits under Medicare Part A and/or Part B.

Medicare Part D coverage is available:

  • Through a stand-alone Medicare Part D Prescription Drug Plan — you can add this benefit to your Original Medicare coverage. You can enroll in any Part D Prescription Drug Plan that serves the area where you live.

  • Through a Medicare Advantage Prescription Drug plan — you can get a Medicare Advantage (Part C) plan that includes prescription drug coverage, so that you get all your Medicare benefits under one plan.

If you have Medicare Part A and/or Part B and you don’t have other drug coverage, you should enroll in Part D even if you currently are not on any medications. A premium penalty will be charged if you delay enrollment in Part D

What’s the Difference between Medicare Advantage and Medicare Part D?

Medicare Advantage – also known as Medicare Part C – requires that you have both Medicare Part A and Part B, while a Part D plan can work with one or the other.

Medicare Advantage plans can be separated into two general groups:

  • Medicare Advantage plans with prescription drug coverage (MAPDs)

  • Medicare Advantage plans without prescription drug coverage (MAs).

A Medicare Advantage plan (MA or MAPD) is also known as a Medicare Part C plan.

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