Prescription Drug Plans: Understanding Your Options and Enrollment

Kathleen Bennett
5 days ago
2 min read

Medicare Part D, Prescription Drug Plans (PDPs), play a vital role in managing your prescription medication costs, but they also come with complexities that require careful consideration. This blog shares the basics of PDPs.

What are Prescription Drug Plans (PDPs)?

Prescription Drug Plans (PDPs) were introduced as part of the Medicare program in December 2008 under President George W. Bush’s administration. They provide optional prescription drug coverage to anyone enrolled in Medicare.

You can obtain this coverage through a Medicare Advantage plan (Medicare Part C) that includes prescription benefits or by enrolling in a stand-alone PDP. However, PDP plans are not designed to cover 100% of your prescription drug costs. You will likely encounter costs such as premiums, co-payments, co-insurance, and deductibles, which vary depending on the specific plan you choose.

Who is Eligible for a PDP?

To enroll in Medicare Part D, you must meet the following criteria:

Be entitled to Medicare Part A and/or enrolled in Medicare Part B. This means you must be older than 65 or have a disability that qualifies you for Medicare coverage.
Select a Medicare-approved plan available in your service or Zip code area.

Get help signing up for a PDP by contacting a licensed agent at Hillock Insurance.

When Can You Enroll in a PDP?

You may choose to enroll in a PDP during any of these periods:

Initial Enrollment Period: When you first become eligible for Medicare at age 65 or after 24 months of receiving disability benefits.
Annual Enrollment Period (AEP): Each year on October 15 - November 7, you will have the opportunity to enroll or shop your PDP to check for better rates and/or coverage. Changes will go into effect on January 1.
Special Enrollment Periods: If you’re already in a Medicare Advantage plan, your enrollment options may differ based on your circumstances?

Why Choose a PDP?

Prescription drug coverage helps mitigate the cost of necessary medications. These medications tend to add up quickly, especially as we age and tend to need more medical care.

PDPs vary widely depending on your location, medications, and budget. The plans available in rural areas like Wallowa County differ vastly from those available in larger cities. Consult with a licensed Medicare agent to evaluate your location, current list of medications, and budget to find a plan that suits your needs.

Why Does PDP Enrollment Timing Matter?

If you don’t sign up for a PDP when first eligible and don’t have other creditable coverage, you’ll likely incur a late enrollment penalty. Enrolling on time helps you avoid this penalty and ensures that you have access to affordable prescription drug coverage.

If you have questions about Prescription Drug Plans or need help deciding which plan is right for you, please contact us. Our licensed health insurance agents are here to guide you every step of the way.

This blog is for informational purposes only and not intended as advice. For personalized assistance, consult a licensed health insurance agent. Call us at 541-426-4206 to schedule an appointment.