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What is Medicare Part D?

Medicare Part D, also known as a PDP, first came on the scene in December 8, 2003 with the passing of the Medicare Prescription Drug Improvement and Modernization Act. This law implemented an elective drug benefit for Medicare beneficiaries and established the Medicare Part D program as we know it today.

Anyone on Part A or Part B Medicare is entitled to prescription drug coverage. You can’t be denied for health issues and there are no physical exams required. As soon as you become eligible for Medicare, you can volunteer to join Medicare Part D which is drug coverage. If you have switched from Medicaid to Medicare, you are required to enroll in Part D to get your prescriptions.
Every plan has a list of drugs that they cover and certain medications may not be on the list. There are six classes of drugs and the plan must cover at least two of the drugs within each class. The six classes are: anticancer drugs, antiretrovirals, antidepressants, anticonvulsants, antipsychotics and immunosuppressants. There are drugs that are excluded from Medicare Part D coverage by law. These include: weight medications, cosmetic, fertility, anti-anxiety, erectile dysfunction, cosmetic use and over-the-counter medications.

If you don’t enroll in Medicare Part D, make sure you have other creditable prescription drug coverage, which is insurance that is as good as the standard Medicare prescription drug benefit. If you don’t enroll in Medicare Part D when you’re first eligible and go without creditable prescription drug coverage for 63 days in a row or more, you could face a late-enrollment penalty if you sign up for Part D later on. This penalty comes in the form of an extra cost that is added to your monthly Medicare Part D premium; you may have to pay this higher premium permanently.