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, also called PDPs, combine prescription coverage with Original Medicare and may also work with Medicare Cost Plans, Medicare Medical Savings Account Plans and Medicare Private Fee‑for‑Service Plans.
The other option is Medicare Advantage Plans that include prescription coverage. These plans operate similarly to HMO or PPO plans and provide Part D drug benefits together with Part A and Part B coverage. To join a Medicare Advantage plan with drug coverage (an MA‑PD), applicants must already have Part A and Part B and must live in the plan's service area.
For more background on how Medicare and related programs fit together, see Understanding Medicare, Medicaid, and Life Insurance.
When to Join
The annual opportunity to join, switch or drop a Medicare drug plan runs from October 15 to December 7. Changes made during this period, including new enrollments, take effect on January 1 of the following year.
When individuals first become eligible for Medicare, they may join during a special seven‑month Initial Enrollment Period that includes the three months before the month of their 65th birthday, the month of their birthday, and the three months after their birthday. People who become eligible because of disability have a similar seven‑month period tied to their 25th month of disability.
Individuals who receive extra help with prescription drug costs may join, drop or switch a Medicare drug plan at any time.
Periods of Special Enrollment
Members normally remain enrolled for the calendar year, but in some situations they may be able to join, drop or switch Medicare prescription plans outside the annual window.
- After moving out of a plan's service area.
- After losing creditable prescription coverage from another provider.
- While living in an institution or convalescent facility.
How to Join a Plan
The first step is to choose a plan and complete its enrollment application online or by mail. Visit the official Medicare website to find the online application, or request a paper form to mail in.
You can also enroll by calling the plan's customer center or by calling 1‑800‑MEDICARE to request information or forms. When enrolling, you will need to provide your Medicare number and the date your Part A or Part B coverage began; this information appears on your Medicare card.
Keep in mind that joining a Medicare Prescription Drug Plan may affect existing coverage under a Medicare Advantage plan with drug benefits. If you have questions about how a change will affect your overall coverage, be sure to Understanding Medicare and Medicaid or discuss your options and next steps with a representative or talk to an agent.
Frequently Asked Questions
When is the annual enrollment period for Medicare drug plans?
The annual period to join, switch, or drop a Medicare drug plan runs from October 15 to December 7, with changes effective January 1.
Can I enroll in a Part D plan when I first become eligible for Medicare?
Yes. You have a seven‑month Initial Enrollment Period that includes the three months before your 65th birthday month, the birthday month, and the three months after.
What if I move or lose other prescription coverage?
Moving out of a plan’s service area or losing creditable drug coverage are qualifying events that may allow you to change plans outside the annual enrollment period.
Will joining a Part D plan change my Medicare Advantage enrollment?
Joining a standalone Part D plan while enrolled in a Medicare Advantage plan with drug coverage can affect your Advantage enrollment; confirm details with your plan before making changes.