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Your Most Important Medicare Part D Questions Answered

By Sherry Kahn October 09, 2016 Health and Fitness

Most Medicare Advantage Plans include prescription drug coverage. With Original Medicare, you need to enroll in a Part D plan to obtain drug coverage.

The timeframe for making changes in your drug coverage plan is October 15 – December 7, 2016, the same timeframe as for Original Medicare (Parts A and B) and Medicare Advantage (Part C).

How Do I Enroll for Medicare Part D?

You are able to enroll in a Part D plan when you initially enroll in Medicare. If you don’t enroll in Part D at the same time, you will face a late enrollment penalty.

The cost of the penalty is based on the number of full, uncovered months you were eligible for but didn’t join a Part D plan or have creditable drug coverage (e.g. from a current or former employer). That penalty will remain for as long as you have Part D coverage.

How Do I Make a Switch?

Simply join a different plan during Open Enrollment. You don’t need to notify your current plan. If you have a Medicare Advantage Plan and join a Part D plan, you will be automatically switched from Medicare Advantage to Original Medicare.

What do the Medicare Ratings Mean?

This year Medicare has added star ratings to Part D plans. The Open Enrollment Period for switching to a 5-star plan (the highest rating) is December 8, 2016 – November 30, 2017. Visit this link to learn more about the ratings.

Are There Penalties?

Besides the penalty for late enrollment, you will also be penalized anytime you are without drug coverage for 63 days or more.

What if the Drug Coverage Changes?

Formularies can change during the year. Covered medications can be added or deleted, or one generic can be substituted for another for treating the same condition. If a substitution occurs with a drug you take, contact the doctor who prescribed it as the new one may have different side effects than the original.

What if I Need an Expensive Drug That’s Not in My Formulary? has a rigorous verification and certification process for finding and comparing prices of reputable online licensed pharmacies. These foreign pharmacies, many in Canada, can legally provide a 3-month supply of branded drugs with your doctor’s prescription at substantial savings.

All large pharmaceutical companies have manufacturing plants around the globe that must meet the same FDA standards as U.S. plants. Because overhead costs are much lower, the prices are also lower. Generic drugs, however, are cheaper in the U.S. due to increased competition.

For more information on Medicare, visit my website.

Have you made switches to your coverage? Do you have suggestions for others? Have you found a great Medicare Part D plan? Please share your experiences with our community.

Editor’s note: nothing in this article should be considered medical or financial advice.

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The Author

Sherry Kahn, MPH, is a health educator, author and marketing communications consultant. A former UCLA Medical Center principal editor and Reuters medical journalist, Sherry’s career has taken her into all areas of the U.S. health system. Her most recent book is Surviving the U.S. Health System: Insurance, Providers, Well Care, Sick Care. She has presented at major conferences and made numerous media appearances, including on The View. Connect with Sherry at and

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