Medicare Part D Prescription Drug Plans: Everything You Need to Know
Medicare prescription drug coverage (Part D) helps cover the cost of prescription medications — both brand-name and generic — at participating pharmacies. Even if you don’t take many prescriptions now, enrolling in a Part D plan helps protect you from unexpected drug costs and potential late enrollment penalties.
Frequently Asked Questions About Medicare Prescription Drug Plans
Why Should I Get a Medicare Prescription Drug Plan?
Even if you currently take few or no prescriptions, most people eventually need medication. Enrolling now:
Provides financial protection against future drug costs
Helps you avoid late enrollment penalties
Gives you peace of mind as you age
Who Can Get Medicare Prescription Drug Coverage?
Anyone with Medicare Part A or Part B is eligible for Medicare Part D, regardless of income, health status, or current prescription needs.
When Can I Enroll in a Medicare Prescription Drug Plan?
You can enroll:
During your Initial Enrollment Period (IEP): 3 months before through 3 months after you turn 65
If disabled: From 3 months before through 3 months after your 25th month of receiving disability payments
Later on during:
The Annual Enrollment Period (AEP): Oct 15 – Dec 7
A Special Enrollment Period (SEP) if certain life events occur
Delaying enrollment without creditable coverage may lead to penalties.
What Should I Do Before Making a Decision?
Review your current drug plan and upcoming changes
Compare other plans in your ZIP code using the Medicare Plan Finder
If switching, enroll early to avoid pharmacy delays in January
Your new plan will automatically replace your old one
How Do I Get a Medicare Prescription Drug Plan?
You must have Medicare Part A or B
You must live in the plan’s service area
Plans are offered by private insurers; speak to a Medicare Mall specialist for personalized help
How Much Does a Part D Plan Cost?
Costs vary by plan and include:
Monthly premium (higher if your income exceeds a certain level)
Annual deductible (up to $545 in 2025)
Copayments or coinsurance for medications
Your cost may be higher based on your modified adjusted gross income from your IRS return two years ago.
What If I Have Limited Income or Resources?
You may qualify for Extra Help, which:
Covers premiums, deductibles, and most drug costs
Is available through Social Security at ssa.gov or 1-800-772-1213
Offers assistance even if you don’t qualify for Medicaid
How Does Medicare Prescription Drug Coverage Work?
You can get Part D through:
A standalone Part D plan
A Medicare Advantage plan with drug coverage
Most plans include:
A monthly premium
An annual deductible
Copayments or coinsurance per prescription
Costs vary based on the plan and medications you take.
Why Is Creditable Coverage Important?
If you have existing creditable drug coverage (as good as or better than Medicare’s), you can delay enrolling in Part D without penalties.
If your coverage isn’t creditable, you’ll pay a penalty of 1% per month for every month you delay.
Are You Paying the Right Amount for Your Prescriptions?
If you qualify for Extra Help, you should pay reduced or no:
Premiums
Deductibles
Copays
If you’re overpaying:
Contact your plan and provide proof of your Extra Help eligibility
Acceptable documents include:
A purple, orange, yellow, or green Medicare notice
A Social Security award letter
Can I Get a Refund If I’ve Paid Too Much?
Yes — if you’ve overpaid since qualifying for Extra Help:
Save your receipts
Contact your Part D plan to request reimbursement
Our Commitment
At Medicare Mall, we help you find the:
Lowest premiums
Lowest deductibles
Best plan coverage
Least exposure to the “donut hole”
Want to compare plans tailored to your needs?
Use the official Medicare Plan Finder or contact a Medicare Mall specialist today using the button below.