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¿Qué es Medicare Parte D?

Senior man using Medicare Part D to get his prescription medicine at the pharmacy

Are prescription medicines part of your everyday health care needs? Then it's a smart idea to include drug coverage in your health care plan. When you're turning 65 and applying for Medicare, you can explore how Medicare Part D covers prescription drugs.

Original Medicare (Part A and Part B) only covers prescription drugs you receive during a hospital stay or if you have outpatient surgery. Private insurers such as Anthem offer Part D plans so you can make sure all your medications are covered.

What does Medicare Part D cover?

Part D is an optional insurance plan you can add to your Part A and Part B Medicare coverage. Medicare Part D, which covers prescription drugs, can help you save money. This is especially true if you're managing a condition that requires regular medication.

When are you eligible for Medicare Part D?

The first enrollment period for Part D is the Initial Enrollment Period (IEP). That's the seven-month window that includes:

  • Tres meses antes de cumplir 65 años
  • El mes en que cumples 65 años
  • Tres meses después de cumplir 65 años

During this time, you can apply for Part D coverage along with Medicare Part A and Part B. Even if you are not taking prescription medications, it's best to enroll in Part D as soon as you're eligible to avoid penalties. You can still add Part D coverage after your IEP. You can make changes to your plan, including adding coverage, during the Annual Enrollment Period from October 15 to December 7 each year.

What types of prescription medications do you take?

There are lots of Part D prescription drug plans and they cover different medications. Be sure to find a plan that covers the medicines you need and take regularly.

Most plans have a formulary, which is a list of drugs the plan covers. While there are many drugs Medicare requires Part D plans to cover, you still want a plan that fits your personal prescription needs.

Just remember, there are laws that do not allow Medicare Part D insurers to cover certain categories of drugs. Estos incluyen:

  • Non-prescription medications
  • Medications for anorexia, weight loss or weight gain
  • Medicamentos utilizados para favorecer la fertilidad.
  • Drugs for cosmetic purposes or to promote hair growth
  • Cough or cold medications
  • Prescription vitamins and minerals
  • Drugs for sexual or erectile dysfunction

Are generic versions of your prescription drugs covered?

You can save money if you take generic instead of brand-name drugs. Look for Part D plans that have tiers comparing generic and brand-name drugs. Tier one and Tier two usually cover generic versions of medications that may cost you nothing or very little compared to brand medications.

What plan is best when you don’t have prescriptions right now, but want that coverage for peace of mind?

If you do not currently have prescriptions for any medical needs but still want a coverage safety net, look for a plan with a low monthly premium and/or deductible. That way you have the coverage if and when you need it.

Remember, if you don't sign up for a Part D plan when you're first eligible, or you've gone 63 days or more without creditable drug coverage after your IEP, you'll pay a monthly late enrollment penalty while you have Part D coverage. While the fee is typically only a few dollars each month, you can avoid it.

Medicare Part D versus Medicare Advantage plans

Another way to get prescription drug coverage is through a Medicare Advantage plan or Part C. Along with covering prescription drugs, many Medicare Advantage plans offer extra benefits that help you save more money in the long run.

You can choose Part C or Part D, but you can't have both at the same time. That's why many people choose Part C plans, as they cover drugs and a lot more. Medicare Advantage plans may also include:

  • Cuidado dental de rutina, que incluye limpiezas, radiografías y dentaduras
  • Cuidado de visión de rutina, que incluye lentes de contacto y anteojos
  • Cuidado de la audición de rutina, que incluye dispositivos para la audición
  • Beneficios de acondicionamiento físico, que incluye clases de gimnasia

Much like Part D plans, you can get Medicare Advantage plans through private insurers like Anthem. This gives you more plan options so you can find the plan that best fits your needs.

Applying for Medicare with Part D in mind

When applying for Medicare, consider whether or not you need prescription drug coverage. If you decide to add a Medicare Part D plan, ask questions and review your selected plan to make sure the medicines you use are included and affordable for you.

Explore all your options for Medicare prescription drug plans, including comprehensive Medicare plans.

Busca hoy planes de Medicare (en inglés)

Y0114_20_113221_U   Aceptado por los CMS el 9/10/19

Anthem Blue Cross and Blue Shield es el nombre comercial de: en Colorado, Rocky Mountain Hospital and Medical Service, Inc. Los productos del plan HMO están suscritos por HMO Colorado, Inc. En Connecticut: Anthem Health Plans, Inc. En Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. En Indiana: Anthem Insurance Companies, Inc. En Kentucky: Anthem Health Plans of Kentucky, Inc. En Maine: Anthem Health Plans of Maine, Inc. En Misuri (a excepción de 30 condados del área de Kansas City​​​​​​​): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC) y HMO Missouri, Inc. RIT y ciertas afiliadas administran los beneficios que no son del plan HMO suscritos por HALIC y los beneficios del plan HMO suscritos por HMO Missouri, Inc. RIT; y ciertas afiliadas solo prestan servicios administrativos a planes autofinanciados y no suscriben beneficios. En Nevada: Rocky Mountain Hospital y Medical Service, Inc. Los productos del plan HMO están suscritos por HMO Colorado, Inc., cuyo nombre comercial es HMO Nevada. En New Hampshire: Anthem Health Plans of New Hampshire, Inc. Los planes HMO están administrados por Anthem Health Plans of New Hampshire, Inc. y suscritos por Matthew Thornton Health Plan, Inc. En Ohio: Community Insurance Company. En Virginia: Anthem Health Plans of Virginia, Inc. opera comercialmente con el nombre Anthem Blue Cross and Blue Shield en Virginia, y su área de servicio abarca todo Virginia con excepción de Fairfax, Vienna y el área este de State Route 123. En Wisconsin: Blue Cross Blue Shield of Wisconsin (“BCBSWI”), que suscribe o administra las pólizas del plan PPO y las pólizas de indemnización, y suscribe los beneficios fuera de la red de las pólizas POS ofrecidas por Compcare o WCIC; Compcare Health Services Insurance Corporation (Compcare) suscribe o administra las pólizas HMO y Wisconsin Collaborative Insurance Company (WCIC) suscribe o administra las pólizas HMO o POS de Well Priority. Licenciatarios independientes de Blue Cross and Blue Shield Association. Anthem es una marca comercial registrada de Anthem Insurance Companies, Inc. Los nombres y los símbolos de Blue Cross and Blue Shield son marcas comerciales registradas de Blue Cross and Blue Shield Association. La utilización de los sitios web de Anthem constituye su aceptación de nuestros términos de uso.