How to Apply for Medicare Part D Coverage

Medicare is a federal health care program designed for the elderly and disabled in the United States. Medicare consists of different “parts,” including Part A (hospital insurance), Part B (medical insurance) and finally, Part D, which is the prescription drug benefit. Part D is an optional benefit, and there are certain things to keep in mind when signing up for the first time.

Have an inventory of all prescription drugs that you take handy. Make a list that includes the names (both brand and generic if you can take a generic version), the frequency you take them and your dosage. It is also helpful to have a list of the pharmacies you prefer to use.

Ensure that you are in a designated enrollment period. You cannot sign up for a Part D plan just any time in the year. Medicare has designated certain periods that are approved for signing up. If you are new to Medicare, then you are more than likely in your initial enrollment period, which is a seven month period that starts when you first become Medicare-eligible. If you are no longer in your initial enrollment period, then you can only sign up for Part D during the annual coordinated election period, which lasts from November 15 through December 31 for coverage effective on January 1.

In some instances, you may qualify for a special enrollment period, which is when you are granted a one-time enrollment period outside of the designated enrollment periods by the Social Security Administration. There are several ways to get a special enrollment period, such as losing creditable drug coverage, being enrolled in a low-income subsidy program (such as Extra Help) or having lost or needing to switch drug coverage due to marketing fraud.

Select a plan. If you haven’t already done this step, you can browse and compare plans using Medicare.gov’s online plan finder tool. This tool helps Medicare beneficiaries find plans in their area (see Resources).

Call the plan you want to sign up for. Before you enroll, confirm all the information you have about the plan. Double check that it covers all of the drugs you take and ask if there are any restrictions, such as prior authorization or step therapy (which is when they require you to take other, less expensive drugs before they will cover it) placed on the drug. Find out if your preferred pharmacy is an in-network pharmacy. Finally, ask about the price of the plan, including premiums, deductibles and co-payments.

Enroll in the plan. When you call the plan, ask about the preferred enrollment method. Some plans offer online enrollment forms, while others can enroll you over the phone. Some prefer you to send in an application. You can also enroll directly through Medicare and for some plans, by going to Medicare.gov. Medicare Interactive cites calling 800-MEDICARE as the best way to enroll in a plan because it is the easiest way to avoid any “administrative errors.”