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When can I enroll in Medicare Part D?

Just the essentials...

  • You can choose to enroll in all Medicare programs at once or once a year during the enrollment period

  • If you qualify, you should sign up for Medicare Part D during your initial enrollment period (IEP) to avoid a penalty

  • You can switch from Medicare Advantage to Medicare Part D during the Disenrollment Period

When can I enroll in Medicare Part D?

When you enroll in Medicare, you can choose a Medicare Advantage Plan (Part C) or Medicare Part D, which covers prescription coverage as well.

It is possible to enroll in both C and D along with Medicare A and B. It’s not necessary to apply for Medicare every year, but you do get the chance to review your choices every year. However, there is only a small window of time each year where plan changes will be accepted.

Medicare has several different programs available to enrollees. If you are eligible, you can enroll in Medicare Part D: Prescription Drug Benefits during your initial enrollment period.

Your initial enrollment period  for Medicare Part D is usually the same length of time as Part A and B, which is a seven month period. The seven-month period begins three months before a person’s 65th birthday.

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What happens if you don’t enroll in Medicare Part D during your initial enrollment period?

When can I enroll in Medicare Part D? - Medicare Enrollment Form

If you fail to enroll in Medicare Part D during your initial enrollment period, you won’t have another opportunity until the open enrollment period begins.

Open enrollment starts in the fall of each year and runs from October 15th to December 7th. Any registrations or changes made to Part D coverage during this time become effective January 1st of the following year.

Enrolling during this period gives you access to coverage, but it may include a penalty fee.

Part D Penalties

Medicare Part D covers prescription drugs. If you sign up late, outside your seven month IEP, you may have to pay the penalty.

If you signed up for Medicare Part D, had a penalty assessed, and weren’t 65 yet, the penalty fee no long applies after your 65th birthday because a new IEP will have started.

Special Enrollment Periods and Who Can Apply

When can I enroll in Medicare Part D?

Some individuals may qualify for a special enrollment period. During this timeframe, individuals can apply for Medicare Part D coverage; despite their IEP and without any penalties associated with the cost.

To qualify for special enrollment privileges, you must meet one of following conditions.

  • Lost employer drug coverage
  • Qualified for Extra Help

What is Extra Help and who gets it?

Extra Help is a federally-funded government Social Security Program. It is officially known as the Low Income Subsidy (LIS). The program is available to low-income Medicare enrollees.

To qualify, a person must be on Medicare, have a low household income, and no or few assets. The program helps Medicare enrollees pay for associated medical costs including:

  • Deductibles
  • Copays
  • Premiums
  • Prescription Coverage

When Does Medicare Part D Coverage Began

It’s important to sign up for Medicare Part B in the three months before you turn 65. If you sign up for the program during that time, your coverage will start as soon as you are eligible for Medicare.

If you wait until the month you are eligible for coverage, the benefits will begin on the first day of the new month after you enrolled.

How do you switch to Medicare D from Medicare Advantage?

When can I enroll in Medicare Part D?

If you opted for Medicare Advantage rather than traditional Medicare and wanted to make a switch you can. Every year, there is a Medicare Advantage Disenrollment Period.

During this time, enrollees can opt out of their Medicare Advantage plan and switch to original Medicare. Unless an enrollee had Medicare C and D, they would need to add prescription coverage to their policy.

An easy way to get prescription coverage with your Medicare A and B plans is to choose Medicare Part D. Choosing this option can be done during the disenrollment period without penalty to the enrollee.

If a beneficiary chooses this option, their existing Medicare Advantage plan will be allowed to expire.

At that point, usually the 1st of the year, an enrollee will have Medicare Parts A, B, and D, which means they will use their Part D program to obtain prescription drugs rather than their Advantage plan.

It’s recommended that enrollees choose Medicare Part D immediately when they switch from Medicare Advantage to traditional Medicare. Otherwise a beneficiary will have no prescription coverage. The enrollee will have until February 14th of the next calendar year to choose prescription coverage.

If no coverage is selected at that time, the beneficiary will have to wait until the next enrollment period to choose prescription coverage. During this period, the enrollee will not have prescription drug coverage.

Unless they have another plan, such as an employer’s insurance, the responsibility for drug coverage will be an out of pocket cost.

Prescription drugs are expensive. Many individuals count on medications to keep them well throughout the year. Without prescription coverage, some patients may not be able to afford their prescriptions, which could put them at great risk of falling ill or dying.

To avoid not being able to access affordable drug coverage, Medicare enrollees should consider and enroll in a Medicare D plan.

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