When and how to sign up for Part D

You sign up for Medicare Part D (prescription drug coverage) during your Initial Enrollment Period, which is the seven-month window that starts three months before the month you turn 65. For example, if you turn 65 in June, your enrollment period runs from March through September. You can sign up online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office.

If you miss this window, you can still sign up during the General Enrollment Period (January 1 through March 31 each year), but you will pay a late enrollment penalty on top of your monthly premium for as long as you have Part D coverage. The penalty is roughly 1% of the national average Part D premium for each month you went without coverage.

There are also Special Enrollment Periods if you lose coverage through an employer, move to a different state, or experience other may have access to life changes. These let you sign up outside the normal windows without penalty.

Key Takeaways

  • Your Initial Enrollment Period is seven months long, starting three months before the month you turn 65, and this is when you should sign up to avoid penalties.
  • You can enroll through Medicare.gov, by calling 1-800-MEDICARE, or at your local Social Security office.
  • Missing your enrollment window means paying a late penalty on your premium for the rest of your coverage, even if you sign up later.
  • Part D plans vary in which drugs they cover and what you pay, so comparing plans before you choose matters for your specific medications.
  • You can change plans once a year during the Annual Enrollment Period (October 15 through December 7).

What you need to have ready before you sign up

Gather your Medicare card (or Social Security number if you do not have the card yet), a list of all the prescription medications you currently take, and information about any drug coverage you have through an employer or union. If you are signing up online, you will also need to create or log into your Medicare.gov account.

The medication list is the most important piece. When you are comparing plans, you will want to check whether each plan covers your specific drugs and at what cost. Some plans cover certain medications only if you try a cheaper alternative first, or only after you pay a certain amount out of pocket. Knowing your current medications ahead of time means you can make a real comparison instead of guessing.

How to compare Part D plans

Medicare.gov has a tool called the Plan Finder that shows you all the Part D plans available in your area. Enter your zip code, select the month you want coverage to start, and type in each of your medications. The tool will show you which plans cover each drug, what your copay or coinsurance will be, and the total estimated cost for the year based on your prescriptions.

Plans are grouped into five categories based on how much you pay: Basic, Enhanced, Intermediate, Advanced, and Premium. All plans must cover the same list of drugs (called the formulary), but they can charge different amounts for the same medication. A plan that costs less per month might charge more per prescription, or vice versa. The Plan Finder calculates your total out-of-pocket cost, which is usually more useful than comparing monthly premiums alone.

Pay attention to whether your pharmacy is in the plan's network. Some plans have preferred pharmacies where you pay less, and using an out-of-network pharmacy costs more. If you use a mail-order pharmacy or a specialty pharmacy for expensive medications, check that the plan covers it.

The enrollment process step by step

Online at Medicare.gov: Log into your account, go to "Enroll in a plan," select Part D, enter your zip code and start date, review plans using the Plan Finder, and click "Enroll" on the plan you choose. You will get a confirmation number on screen and by email.

By phone at 1-800-MEDICARE: A representative will ask for your Medicare number, medications, and preferred pharmacy, then walk you through available plans and enroll you over the phone. The call usually takes 20 to 30 minutes. You will receive written confirmation in the mail.

In person at Social Security: Bring your Medicare card, medication list, and pharmacy information. A representative will help you compare plans and enroll. You will get a receipt on the spot and confirmation in the mail within two weeks.

What happens after you sign up

Your coverage starts on the first day of the month you selected during enrollment. You will receive an insurance card in the mail about two weeks before your coverage begins. Use this card at the pharmacy when you fill prescriptions. If your coverage starts on January 1, expect the card to arrive by mid-December.

Your plan will send you a detailed document called the Summary of Benefits and Coverage (SBC) that lists exactly which drugs are covered, what you pay for each, and any restrictions. Read this carefully when it arrives, because it may differ from what the Plan Finder showed you. If a drug you take is not covered or the cost is higher than expected, you can request an exception from your plan, or you can switch plans during the next Annual Enrollment Period.

Changing your plan or coverage

You can change Part D plans once per year during the Annual Enrollment Period, which runs from October 15 through December 7. Changes take effect January 1. You can switch to a different plan, drop Part D coverage entirely (if you have other drug coverage), or add Part D if you did not have it before.

If your medications or pharmacy situation changes during the year, you cannot switch plans until the next Annual Enrollment Period unless you have a may have access to life event. may have access to events include losing employer coverage, moving out of your plan's service area, or becoming newly may be able to access for Medicaid. If you experience one of these, you have 63 days to make a change.

What to do if you cannot afford your medications

If your Part D plan's copays or coinsurance are too high, talk to your doctor about generic alternatives or lower-cost medications that treat the same condition. Many drugs have generic versions that cost significantly less and work the same way.

You may also be may be able to access for the Low-Income Subsidy (LIS), a program that helps people with limited income pay Part D premiums and out-of-pocket costs. To check whether you may have access to, contact Social Security at 1-800-772-1213 or visit your local Social Security office. Income limits vary by state but are generally around $20,000 per year for individuals.

Some pharmaceutical companies also offer patient information programs that provide free or reduced-cost medications to people who meet income requirements. Ask your doctor or pharmacist whether your medications have these programs.

Questions to ask your doctor or pharmacist

Before you finalize your plan choice, ask your doctor or pharmacist: "Are there generic versions of my medications that would work just as well?" and "Does my pharmacy accept Medicare Part D plans?" You can also ask whether any of your medications have patient information programs if cost is a concern.

If you are already enrolled and your plan does not cover a medication your doctor prescribed, ask your doctor to request a coverage exception from your plan. Some plans will cover drugs not on their formulary if your doctor explains why that specific drug is medically necessary for you.

Frequently Asked Questions

What is the difference between Part D and Part B?

Part B covers doctor visits, lab work, and medical equipment. Part D covers prescription drugs only. You can have both at the same time. Part B is automatic when you turn 65, but Part D requires you to sign up separately.

Can I sign up for Part D after I turn 65?

Yes, but only during the General Enrollment Period (January 1 through March 31) or if you have a may have access to life event. If you sign up after your Initial Enrollment Period ends, you will pay a late penalty for as long as you have Part D coverage.

Do all Part D plans cover the same medications?

All plans must cover at least two drugs in each medication category, but they can charge different amounts and may have restrictions like requiring you to try a cheaper drug first. Use the Plan Finder to check coverage for your specific medications before you choose a plan.

What if my plan stops covering a medication I need?

You can request a coverage exception from your plan, and your doctor can submit the request on your behalf. If the plan denies it, you can appeal or wait until the next Annual Enrollment Period to switch to a plan that does cover the drug.

Can I have Part D and employer drug coverage at the same time?

Yes, but tell your employer's benefits office that you have Part D so they can coordinate coverage. If your employer coverage is as good as Part D (called "creditable coverage"), you can delay signing up for Part D without penalty when you retire.