There are two plan options for Medicare prescription drug coverage. The first way to obtain coverage is by applying for a Medicare Prescription Drug Plan. These plans, which are also called PDPs, combine prescription coverage with Original Medicare. In addition to this, they may combine coverage with Medicare Cost Plans, Medicare Medical Savings Account Plans and Medicare Private Fee for Service Plans. Another way to obtain coverage is through Medicare Advantage Plans. These are similar to HMO, PPO or Medicare health plans offering prescription coverage. With these plans, individuals enjoy all the Part A and B coverage provisions on top of prescription coverage from Part D. These plans are also called MA-PDs. In order to qualify for consideration for Medicare Advantage Plans, applicants must already have Part A and B coverage. Applicants must also live in the service area of the Medicare drug plan they're trying to join.
When to Join. The time to join, switch or drop a plan is between October 15 and December 7. During this time, applicants are welcome to change or drop. In addition to this, new members are welcome to apply. All changes and new enrollments are effective on January 1 of the following year. When individuals first become eligible for Medicare, they are allowed to join during a special seven-month period. This period includes the three months prior to an applicant's 65th birthday, the month of their birthday and the three months following their 65th birthday. Individuals who obtain Medicare due to a disability may join during a similar seven-month period. However, the period includes the three months prior to the applicant's 25th month of disability, the 25th month of disability and the three months following the 25th month of disability. Applicants who miss this deadline will have another special opportunity to apply three months before turning 65 years of age. Individuals who get extra help may join, drop or switch a Medicare drug plan at any point in time.
Periods of Special Enrollment. Members must usually remain enrolled for the calendar year. In some situations, they may be able to join, drop or switch Medicare prescription plans during the following times:
- After moving out of a plan's service area.
- After losing creditable prescription coverage from another provider.
- During time spent living in an institution or convalescent home.
How to Join a Plan. The first step is to choose a plan. Once this is done, enroll on the plan's Web site. Visit Medicare.gov to find the online application. Another option is to complete the application by printing it out or requesting one through the mail. Fill it out and return it in the mail. It's also possible to enroll by calling the plan center. Call 1-800-MEDICARE to obtain information about joining or to request forms.
When joining a Medicare prescription plan, it's necessary to provide a personal Medicare number and the date Part A or B coverage started. To locate this information, look on a personal Medicare card. Keep in mind that joining a Medicare Drug Plan will likely affect an existing Medicare Advantage Plan. If there are any questions or concerns relating to this issue, be sure to speak with a representative. When joining a Medicare Prescription Drug Plan with existing coverage from an Advantage Plan with prescription provisions, Medicare will eliminate enrollment in the Advantage Plan and enroll the individual in Original Medicare.