How To Change A Medicare Part D Plan
Want to know how to change your Medicare Part D plan? Read our guide to learn about key enrollment dates and other essential information you should be aware of concerning prescription drug plans.
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Key Takeaways:
The best time to change a Medicare Part D Plan is during the Open Enrollment Period each year, from October 15 through December 7.
It's important to note that a drug formulary might not include the prescription medications that you need.
It's essential to determine which drug plan and formulary carry the prescription medicines you need to take.
You can also disenroll from your Medicare prescription drug coverage (Part D) during the Open Enrollment Period between October 15–December 7 each year.
Every year, you are allowed to make changes to your Medicare prescription drug coverage, or Medicare Advantage plan, for the upcoming year. The best time to do this is during the
Medicare Open Enrollment Period, from October 15 through December 7.
What is a Medicare Part D Plan?
In 2003, Congress passed a law to create a prescription drug benefit for seniors with Medicare — Medicare Part D.
Before this, seniors paid for their prescription drugs out of pocket. This is because neither Medicare A nor Medicare Part B provides coverage for prescription drugs. To afford the medications they needed, many seniors were cutting back on other essentials like food.
Today, Medicare Part D plans offer drug coverage standards that are set by Medicare. These plans are optional for anyone who is eligible for Medicare. In order to sign up for a Medicare Part D plan, you must first join a Medicare plan that offers prescription drug coverage.
Why Would You Want To Change a Medicare Part D Plan?
Drug coverage in the different plans often differs based on their formularies (the list of prescription drugs a plan covers). The formulary sets different "tiers" and pricing. Medications in a lower tier will cost less than those in a higher tier.
For example, here is a description of tiers from Medicare:
Tier 1— Lowest copayment: most generic prescription drugs
Tier 2— Medium copayment: preferred, brand-name prescription drugs
Tier 3 — Higher copayment: non-preferred, brand-name prescription drugs
Specialty tier — highest copayment: very high-cost prescription drugs
It's important to note that a drug formulary might not include the prescription medications that you need. Also, your doctors may have prescribed additional or different prescription medicines for you since you signed up for a Medicare Part D plan.
Thus, it's essential to determine which drug plan and formulary carry the medicines you need to take. This way, you'll get the best price for them.
What Can You Do During Open Enrollment to Change a Medicare Part D Plan?
During Open Enrollment, you can:
Join a Medicare Part D prescription drug plan if you haven't already
Change from one Medicare drug plan to another
Change to a Medicare Advantage plan from Original Medicare that provides coverage for prescription drugs
Switch from one Medicare Advantage plan that provides prescription drug coverage to another
Change to a Medicare Advantage plan that offers drug coverage from one that doesn't
Note: Due to COVID-19, there's a Special Enrollment Period for Medicare-eligible individuals who missed the Open Enrollment Period. For more information, call 1-800-MEDICARE.
What If You Want To Disenroll From a Medicare Part D Plan?
You can also disenroll from your current Medicare prescription drug coverage (Part D) during the Open Enrollment Period. The change takes effect on January 1 of the next year.
To do this during Open Enrollment:
Fax or mail a signed written notice to the plan letting them know that you want to disenroll
Send a request online to the plan if this option is available
Contact the Medicare Part D plan and request that they send you a disenrollment notice to complete, sign, and send them back. You can find your Medicare Part D plan's contact information on your membership card
Call 1-800-MEDICARE (1-800-633-4227)
Go online to MyMedicare.gov
Note: You can't disenroll from a Medicare Part D plan outside the Open Enrollment period. However, you may be able to do so under special circumstances, as defined by Medicare.
Can You Rejoin a Medicare Part D Drug Plan After Disenrolling?
You can always rejoin a Medicare Part D drug plan in the future.
However, you don't want to go over 63 consecutive days without other creditable prescription drug coverage. If you do:
You must wait for another Open Enrollment Period to sign up for the coverage.
The Medicare Part D drug plan may require that you pay a late enrollment penalty.
What Else Should You Know About a Change To a Medicare Part D Plan?
You should know that you won't have to cancel your old Medicare Part D plan. Your old Medicare drug plan ends when your new drug plan starts.
If you want to switch Medicare Part D plans, you should do this as soon as possible within the October 15 and December 7 time frame each year. This way, you'll have your prescription drug card when your coverage begins so you won't miss filling any of your medications.
After you change Medicare Part D plans, you will receive a letter from your new Medicare drug plan letting you know when coverage starts.
Never reveal personal information over the phone to plans selling Medicare Part D unless you are already a member of the plan.
How Can You Compare Medicare Part D Drug Plans Before Changing?
It's essential that you know what different Medicare Part D Plans cover and what you will have to pay for your prescription medicines.
For more information about Medicare Part D Plans, you can compare them at MyMedicare.gov or discuss plan options with a licensed Medicare insurance agent.
Jackie Trovato is a healthcare and legal writer with nearly 40 years of experience.
