Who Needs Part D

People often purchase Part D if they see a significant, medical need for frequent prescriptions, are covered by only Original Medicare, do not have Part D included in their Advantage plan, or don’t have a Medicare Supplement plan.

Do You Need Prescription Drug Coverage?

The first question in deciding whether or not you need Part D is to determine how often you need prescriptions. More often than not, even if they do not need frequent drugs, individuals find that the security of lower-priced access to the prescriptions they need is worth considering Part D. In fact, according to the Healthcare Leadership Council, 85% of U.S. Seniors are satisfied with their Part D prescription drug coverage.

You Are Only Covered by Original Medicare

With Original Medicare (Parts A and B), you will receive very little (if any) prescription drug coverage. Under Part A, “emergency” drugs needed for immediate, in-hospital care will be covered to a certain extent.

Similarly, with Part B, you can receive very limited benefits limited to in-patient care. Any drugs prescribed for outpatient use are not included. Potential drugs covered under Original Medicare include:

  • Drugs used with an item of durable medical equipment (DME)
  • Injectable osteoporosis drugs
  • Erythropoiesis-stimulating agents (for ESRD treatment)
  • Oral End-Stage Renal Disease (ESRD) drugs
  • Blood clotting factors
  • Shots (vaccinations)

Original Medicare alone, however, does not cover a majority of typical drugs, and do not even fully cover all drugs within the above list. If you are worried that this coverage alone is not enough, you can purchase a Part D plan in addition to Original Medicare.

You Do Not Have an Advantage Plan that Includes Part D

Say, however, that you choose an Advantage plan over Original Medicare. More often than not, Medicare Advantage includes Part D coverage. So, if that’s the case, you’re already taken care of, all you have to do is decide whether or not you actually want the coverage.

But, if your Advantage plan does not include Part D, you will need to purchase a separate, stand-alone plan.

You Do Not Have a Medicare Supplement

You cannot have a Medicare supplement and Part D plan at the same time—you can only have one or the other. So, if you do not have the additional coverage of a supplement, you have the option to purchase Part D separately.

When looking for a Part D plan, whether to add onto Original Medicare or Medicare Advantage, you will have to search and compare what’s available in your area. Price points can vary from provider-to-provider, so it is up to you to find one that fits your needs and budget. However, having an agent from My Healthcare Direct can make a big difference, and make this process significantly easier.

We can help!


Find Out What Health Insurance Works For You

Do you think that Part D may be right for you? Still unsure? We’ll answer your questions directly, and ensure that you are confident in your decisions. Ready to get started? Call My Healthcare Direct at (888) 959-1028 today.