Did you know nearly 90% of older adults take at least one prescription medication? And almost as many—80%—take at least two prescriptions.1 That’s why, for Americans age 65 and older, having good prescription drug insurance is essential.
Medicare Part D provides prescription drug coverage for Medicare enrollees. This insurance is sold through private plans that are approved by Medicare. Sometimes Part D plans are standalone plans; in other cases, they are part of a Medicare Advantage plan.
Can I change my Medicare Part D at any time?
You may find the Part D plan you first enrolled in no longer suits your needs. The good news is most people with Part D are allowed to switch plans once a year, during the Open Enrollment/Annual Election Period (Oct. 15 – Dec. 7). Your old Medicare drug plan coverage will end when your new drug plan coverage begins.
You can also add Part D coverage during the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31) if you’re switching from a Medicare Advantage plan to original Medicare. Medicare Advantage Open Enrollment does not allow for Part D changes for people enrolled in original Medicare (including those enrolled in standalone Part D plans).
If you are receiving the Part D Low Income Subsidy (LIS), also called Extra Help, you can switch plans as often as once per quarter during the first nine months of the year (January – September). Note about LIS/Extra Help: Starting in 2024, Medicare enrollees who are currently receiving Extra Help may be eligible to pay no deductible or premium and have lower copayments for specific drugs. In addition, up to 3 million people not currently receiving Extra Help could become eligible for the program in 2024.
Are there other opportunities to switch Part D plans?
There are additional, specific situations in which you can switch Part D plans. These include:
- You’re moving out of the area your current plan serves.
- You’re entering, leaving, or living in a nursing home.
- Your Part D plan stops serving your area.
- You become eligible for the Extra Help benefit.
Changing drug plan formularies mid-year
Part D plans sometimes change their formularies (lists of covered drugs) during the course of the year. This may happen when new drugs come on or are taken off the market, generic versions of a brand name drug become available, or there are new clinical guidelines about a medication's use. Part D plans are required to provide 60 days’ notice to all plan members about formulary changes.
Take the time to review your plan during Open Enrollment
Since you have limited chances to change your Part D coverage, it’s important to take full advantage of Medicare’s Open Enrollment Period. That time gives older adults an opportunity to customize their benefits and potentially save money. Being actively engaged in your health coverage is a key to healthy aging.
How do I know which Medicare plan is best for me?
For help in deciding which Medicare plan(s) is right for you, consider talking to a licensed Medicare benefits adviser. NCOA has partnered with knowledgeable brokers who are committed to helping older adults choose the right Medicare coverage. These partners all meet our strict Standards of Excellence, which ensures their advice will be practical, easy-to-understand, and focused on your unique needs. Learn more.
Another option is to contact your local State Health Insurance Assistance Program (SHIP) for personalized, one-on-one Medicare counseling. Visit the SHIP website for details.
Sources
1. Merck Manual. Aging and Medications. November 2022. Found on the internet at https://www.merckmanuals.com/home/older-people%E2%80%99s-health-issues/aging-and-medications/aging-and-medications#:~:text=Almost%2090%25%20of%20older%20adults,least%205%20different%20prescription%20drugs
