Part D Options When You Don't Take Prescription Drugs

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I often get calls from beneficiaries wondering if they have to buy a Part D (drug) plan...especially, if they don’t take any medications.

While it’s not required by Medicare, there can be consequences for not buying a Part D drug plan when you’re first eligible for Medicare. Join me in this video to see what options are available if you don’t need (or want) a Medicare drug plan.

Option # -- if you don’t take any prescription drugs is to not buy a Part D plan right now, but wait until you actually need one.

Now, that seems like a common sense approach..and perfectly logical, however, there are some things to keep in mind if you choose this option.

At some point, you will probably need a part d plan, and when this happens,you can’t just buy it and have it start right away. Because, Once you’re out of your enrollment period, you have to wait until the Annual Election Period (10/15-12/7) to enroll and then wait until January 1 for the plan to start.

You may also be hit with a Medicare Part d late enrollment penalty. Now, this isn’t a one time fee. It’s a monthly add on penalty...so, just like it sounds, it’s added to your Part D premium every month for as long as you have a Part D plan.

Now, there are some individuals that are not subject to the late enrollment penalty. And, that includes anyone who is eligible for Extra Help also know as Low-Income Subsidy and anyone who had “creditable coverage”. This is drug coverage through your job, spouse’s job, retiree coverage or VA...and, what’s important is that your current coverage is as good or better than Medicare’s...this is the only way it’s considered Creditable Coverage.

Now, keep in mind that you can’t just tell Medicare you had creditable coverage….you actually have to have proof...and it must be submitted to the Part D company within 30 days of their request.

Let's say you don’t fall into these two categories and you decided not to get a Part D plan when you were first eligible, so you know a penalty is coming your way. And for example sake, Let’s also say that you went 40 months without coverage and now you’re signing up for a Part D plan.

Your penalty is calculated by multiplying 1% of the “national base beneficiary premium” which just means it takes all the Part D premiums and comes up with the average...(so, in 2017 the average Part D premium is $35.63). So, 1% of 35.63 is .36 multiplied by the 40 months you went without coverage. Your Part D penalty is $14.40. Remember, this is a monthly add on penalty to your Part D premium and it will stay with you for as long as you have a Part D plan.

And, it’s important to note that Medicare recalculates this penalty every year with the new base beneficiary premium. And as it increases, so will your Part D penalty.

The second option is to buy a Part D plan when you're first eligible. Since you don't take any medications, it’s not necessary to pay a high premium for a plan. The point is just to have a plan in place to avoid a penalty when you do decide to buy a plan.

Now, with that said, Part D plans are not a one size fits all. Some Part D plans cover certain drugs better than others. So, if your doctor has mentioned the possibility of you taking a particular medication in the near future, you might want to take that into consideration when choosing a plan. But, for most people a low premium plan is the best option. And, in this video I'll provide the steps you need to find the lowest monthly premium Medicare Part D plan.

[Queenie-the-genie]

Since this video is already 5 years old are there new rules now?

[larryweinberg]

appreciate you posting these clarification videos. Keep up the fine work. It makes walking the plank easier to take.

[Irwhodunit]

Excellent. I've been worried sick over having to do all this stuff, but you made the hurt go away; pretty much. When you do this again, please explain all the numbers in the Rx plan comparisons. The premiums are easy to compare but I need help with Preferred Cost Sharing, Standard Cost Sharing, Mail Order, Annual Deductibles, Coinsurance. Thanks!

[Dragan]

As always from Joann and Remedigap, another excellent Medicare video that comprehensive and easy to understand. Thanks again!

[moflo]

The fact that we do not sign up when we retire because we are not on any medications, then to get penalized FOR THE REST OF OUR LIVES IF USING PART D is criminal! We should only be penalized for the amount of time we did not sign up for it, NOT FOR THE REST OF OUR LIVES. Where is this "penalty" money going?

[thomaschadwick]

Thanks Joann,
Your videos are always interesting and informative. You make medicare easy to understand for the lay person. Looking
forward to your next video. Would encourage others to subscribe as we have done.

[paridowlatdad]

I had humans medication
I paid $ 40.00 monthly payment
I paid almost 3 months co pay $32.00
Then I found out my medication were so cheap
I started to buy my medication from wellmart without insurance for three months for the amount of $28.00
Insurance company take advantage of old poor people by getting money from poor and old people daily bread. Now because I did not want to pay some of my salaries to insurance company .and I do not have insurance for my medication I must pay penalty to rich companies. Because they sale cheap medicine very expensive to poor and sick people. Who made this rule and regulation..

[harmoni]

During in the part D program, can your doctor prescribe other medications?

[aztecx]

hi,
i will be turning 65 in sept. of this year so i have been researching everything i can about medicare. i am so glad i came across your channel . you thoroughly explain things in a way we can understand and help us make up our minds on which way to go.. i will watch the rest of your videos and i sub"d. i look forward to your new vids. do you help people with starting our social security portion ? thank you so much..Izzy

[jorgeluna]

What about a cancer pill taken at home such as revlimid or pomalyst. Are they covered in full under part d.

[vochaalloy]

Thanks for your informative videos. I see on the medicare.gov website that I can click on "I don't take any drugs" will that still give me a list of plan D options or do I need to enter a drug, even though I am not taking any at this time, just to see the plan these plans? Thak You

[lynnohrel]

You may receive a low premium but what about the out-of-pocket costs and deductibles

[terrykistner]

Hello I currently have plan G and D for prescriptions live in Reno Nevada how can I speak with you to lower my costs retired 70 years of Age thank you

[markpeters]

Or low cost meds, Costco, Sam's club, Canada. That makes no sense to me!

[Remedigap]

Thanks for watching. Still have questions about Part D or Medigap? Simply ask them in the comments section below.

[birdyboyblue]

Thanks for the information. All the rules of medicare are confusing. About the Part D, if one doesn't have any prescription drugs at the time of enrolling into Part B, and selects some low cost Part D plan just to be enrolled, (1) can that plan be changed in the future to fit a particular prescription without penalty? and (2) if yes, does it have to be changed at the Oct 15 to Dec 7 time frame?

[roger]

Thank you once again, Joann for the information. If I decide to enroll in the low cost plan in the beginning but find a need for a better plan a couple years down the road because I'm on more meds, is the upgrade guarantee issue during the open enrollment or do I have to medically qualify for the change?

[iquanyin]

I get the extra help because I'm get bare minimum disability and SSI. Medicare and Medicaid. Oregon. the state says enroll in part d or they will choose for me. yet online everywhere says it's optional. will I be enrolled anyway? it sure seems mandatory to me. so. tell me what's up,

[ppumpkin]

Here's the problem. With a Part D plan, you are not only paying the monthly premium, but you are also paying MORE for your Drugs. So you are wasting your money. I can buy Edarbyclor for $400 a year without insurance. But if I have insurance it will cost me $800 for the drug. Plus my insurance premium. Also in years where I have excess income I pay a big penalty on my premium. If I get chemo, or I am in the hospital, all my drugs are covered by Part B. So unless you have a catastrophic illness you might as well wait until you get sick until you buy a plan.


If you use Goodrx, you can get a better price than your insurance plan will give you. Also many pharmacuetical companies have discount programs for people who are uninsured. Insurance plans pay higher prices, than they get kickbacks from the Pharmacuetical companies. It's once big pricing scheme. They charge people with insurance more, and people who don't have insurance pay less. And if you have a serious condition and need a lot of drugs, you still pay a lot for that donut hole. So evening having insurance and lots of drugs is never an easy fix.

[manninggrinnan]

Nope, I'm wrong, it might be creditable, meaning it may have some sort of credit applied. ;-)