Medicare topics:

Common questions

Medicare is a national public health insurance program. Here, see common questions about Medicare.

If you have a question that isn't answered here, check out health coverage options under Your Options.

  • If you don't sign up when you're initially eligible, your Part A premium may go up 10 percent. For example, if you wait to sign up for Part A for a year after you were initially eligible, you'll have to pay the increased premium for 2 years (twice as long as the length of time you waited to sign up).
  • If you don't sign up when you're initially eligible, your Part B premium may also go up 10 percent for each 12-month period you could have had it but didn't sign up. This increase in your premium can last as long as you have Part B.
  • If you don't sign up when you're initially eligible for Part D coverage, you may have to pay a late enrollment penalty for the period you went without coverage.

Medicare Part D is for prescription drug coverage. To get Part D, you must join a Medicare plan that offers prescription drug coverage. There are two ways to get Medicare drug coverage:

  • Medicare Part D
  • Medicare Advantage Plan (Part C)

To research available plans or to find which part D plan you have:

  • Create an account (or check your account) at Medicare.gov
  • Call the Senior Linkage Line at 1-800-333-2433
  • Call 1-800-MEDICARE

You can enroll when you're initially eligible for Medicare or during annual open enrollment, which usually takes place from mid-October through mid-December. To learn more, find out how to get prescription drug coverage from Social Security. 

For an introduction to part D and prescription drugs, check out the Medicare Made Clear video (01:55) below.

Medicare part D and prescription drugs

Yes!

Each insurance plan has a list of approved medications, called a formulary. Formularies vary by plan. If your prescription isn't on this list, it won't be covered by your insurance. Also, some drugs are excluded from Part D coverage by law.

If your prescription isn't covered by your insurance, you might:

  • Check with your insurance plan to see if they will cover a generic version of the drug.
  • Ask your doctor to request an exception from the insurance plan. If other drugs may be dangerous or less effective for you, your doctor can ask for something called a formulary exception. Or, your doctor might ask the insurance plan to cover your prescription at a lower cost. This is called a tiering exception. If your insurance plan doesn't agree to the exception, you can file an appeal.
  • If your prescription was covered before you switched plans or before your plan changed its coverage rules, ask your pharmacist to give you a temporary supply of your prescription through your plan's transition refill policy.
  • Apply for a prescription assistance program from NeedyMeds.

Yes. If you have Medicare and Medical Assistance (MA), you need to enroll in a Medicare prescription drug plan.