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Medicare Prescription Drug Plans

Updated: May 8

There are two ways for you to get your drugs covered by Medicare. One way is to purchase a Medicare Advantage Plan that includes a drug formulary (prescription drugs). The second way is to purchase a standalone Prescription Drug Plan, otherwise known as a PDP.

It is important to know if you go without a prescription drug plan that meets Medicare standards, you may be charged a late enrollment penalty if you choose to join a PDP plan later. The amount of the penalty will be added to your Medicare Part D monthly premium. This happens when, for any continuous period of 63 days or more after your Initial Enrollment period is over, you don't have creditable drug coverage. You will pay the late enrollment penalty forever. The penalty will increase the longer you go without credible drug coverage. If you intend to use a plan that is not from Medicare, make sure that it is considered credible coverage by Medicare.

Let's talk briefly about drug plans included within Medicare Advantage Plans. First, if you purchase an Advantage Plan without a formulary (drug list), you CANNOT purchase a standalone drug plan to go with it. Therefore, it is important that you select an Advantage Plan that meets your Medicare requirements and your pharmaceutical requirements.

The standalone Prescription Drug Plan, also known as Part D, is the only Medicare plan you can purchase if you have Part A OR Part B. Advantage Plans and Supplements require BOTH Part A and Part B.

You may want to purchase a standalone PDP to accompany a Medicare Supplement. Standalone PDP's have a monthly premium, many, not all, have an annual deductible. The premiums and drug coverage for PDP's can vary. Check the Plan formularies to assure that you are purchasing a plan that provides the drugs you use in a cost-effective manner. A licensed agent can do this for you.

A PDP is available for enrollment if you choose to stay with Original Medicare (Parts A and B). Again the PDP is the only Medicare Plan that may be purchased if you have Part A OR Part B.

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