
Medicare Part D FAQ
What is a Medicare PDP plan?
A standalone Medicare Prescription Drug Plan (PDP) is a plan offered by private insurance companies that only provides prescription drug coverage. These plans are designed to work alongside Original Medicare (Part A and Part B), which does not include prescription drug coverage.
Who is eligible for a Medicare PDP?
You’re eligible for a Medicare PDP if you’re entitled to Medicare Part A and/or enrolled in Medicare Part B. You must also live in the service area of the Medicare drug plan you want to join.
When can I apply for Medicare PDP Insurance?
You can enroll in a Medicare PDP during your Initial Enrollment Period when you first become eligible for Medicare, or during the Annual Enrollment Period which runs from October 15 to December 7 each year.
What does a Medicare PDP cover?
Medicare PDPs cover a wide range of prescription drugs. Each plan has a formulary, or list of covered drugs, which includes both brand-name prescription drugs and generic drugs. However, the specific drugs covered can vary from plan to plan.
Can I have a Medicare PDP and an Advantage Plan at the same time?
Yes, but only if your Medicare Advantage Plan is a PFFS and doesn’t include prescription drug coverage. If your Medicare Advantage Plan includes drug coverage, you generally can’t join a separate Medicare PDP.
What happens if I don't enroll in a Medicare PDP when I'm first eligible?
If you don’t enroll in a Medicare PDP when you’re first eligible and you don’t have other creditable prescription drug coverage, you may have to pay a late enrollment penalty if you join a plan later.
What if I can't afford a Medicare PDP?
If you have limited income and resources, you may be eligible for Extra Help, a program that helps pay for some to most of the costs of Medicare prescription drug coverage.
Please note that this is a general overview and the specifics can vary depending on individual circumstances and changes in Medicare policy. Always consult with a Medicare representative or a healthcare advisor for personalized advice.