How to know if Medicare Part D coverage is right for you

If you’re approaching – or already past – retirement age, you probably use some form of prescription medication.

Overall, according to the CDC, nearly half of all Americans have used a prescription drug in the past 30 days. But this number skyrockets to 85% of adults aged 60 and up.

For seniors, lipid-lowering drugs, beta-blockers, and anti-diabetic drugs are the three most commonly used, but it seems that nearly everyone is on something.

This is probably one of the biggest reason that Medicare Part D coverage has become so popular in recent years. But what are these plans? Who are they designed for? Exactly what does medicare cover for plan owners? And are you – or your aging parent – eligible?

To clear up the confusion and shed some light on the benefits of this type of health coverage, the following summary presents the facts for you to reference as you make a choice on your plan.

What is Medicare Part D coverage?

Medicare is generally discussed as a single program that is available for all eligible American seniors. While this broad characterization makes sense in most contexts, it does leave some unaware of the general categories.

Medicare is broken up in to several aspects, with Medicare Part A covering in-patient situations (including emergencies in what is usually termed “hospital insurance”) and Medicare Part B cover outpatient care (“medical insurance”). Medicare only covers 80%, to get coverage for the remaining 20% most people buy a supplement plan such as a  Humana Medigap insurance policy.

Medicaid Part C is a supplemental coverage that provides even broader coverage in many ways through an elective additional Advantage plan. And, finally, Medicare Part D concerns prescription drug coverage.

Why would someone need Medicare Part D coverage?

While standard Medicare enrollment entitles everyone to a certain level of care, it doesn’t offer prescription drug cost coverage or reductions. You need to enroll in a Part D plan to realize those additional benefits, and it’s important to know that even these plans can differ depending upon various considerations.

According to the U.S. Centers for Medicare and Medicaid Services, Part D drug costs will depend upon factors including the specific type of drugs you use, the plan you choose, and if your pharmacy is in network, among other factors.

Given all that – combined with the number of seniors requiring medication – it’s no wonder that a Part D plan is now widely seen as necessary. It is a cost-effective option that benefits both for your health and your wallet. 

Who is eligible for Medicare Part D coverage?

Anyone who is eligible for Medicare and has enrolled in Part A and Part B coverage is also eligible for a Part D plan. Access to plans can depend somewhat on your geographical location, but most people have providers in their area.

The process of enrolling is quite simple. The main thing to know is that you want to do it as soon as possible. Even if you are not taking medications on your 65th birthday, chances are that you will in the next few years and there is a late-enrollment penalty. You also need to figure out if they have an attained age policy, which you can read more about at

Getting Medicare Part D coverage

As much as the Medicare system tries to make things simple, there are still misconceptions about its coverage. And the logistics of obtaining prescription drug coverage is one of the biggest. You won’t have this benefit through original Medicare (Parts A and B) alone.

Fortunately, there are a range of excellent Part D plans in the marketplace that can help to overcome some of the gaps and issues with the standard care. So whether you or your loved ones are hitting 65 and looking to be protected for the final phase of life, there are great options out there. 

Just make sure you take advantage to get broadest coverage available at a great price.

Photo by Laurynas Mereckas