Can I Have More than One Medicare Part D Prescription Drug Plan?
Summary: You generally can only have one Medicare Part D plan cover your prescription drugs at a time. However, you can sometimes change plans if you need better coverage.
You generally can’t be enrolled in more than one Medicare Part D plan at the same time. This may be upsetting if you enrolled in a Medicare Part D plan only to discover it doesn’t cover some of your most expensive prescription drugs and another Medicare Part D plan does cover them. Don’t despair. You will have the opportunity to change Medicare Part D plans once a year during the open enrollment period and at other times in specific circumstances.
What are my options for Medicare Part D plans?
To provide prescription drug coverage, the Centers for Medicare & Medicaid Services (CMS) contracts with private insurers. There are two different types of Medicare Part D plans from which you can choose to receive your Medicare prescription drug coverage.
- A Stand-alone Medicare Part D Prescription Drug Plan (often referred to as a PDP) – is designed to work alongside the federal government-administered Medicare Part A and Medicare Part B insurance program.
- A Medicare Advantage Plan with prescription drug coverage combines Medicare hospital and medical (Part A and Part B) and prescription drug (Part D) coverage in a single plan offering. To enroll in a Medicare Advantage plan, you must have both Medicare Part A and Part B. Be aware that while most Medicare Advantage plans include prescription drug coverage, not all do. If you enroll in a Medicare Advantage (MA) plan rather than a Medicare Advantage Prescription Drug (MA-PD plan, you won’t have Medicare Part D prescription drug coverage. And, if you enroll in a stand-alone Medicare Part D Prescription Drug Plan, you will be automatically dis-enrolled from the Medicare Advantage plan and enrolled in Medicare Part A and Part B for your medical coverage.
Know the rules of Medicare Part D eligibility and coverage
Medicare Part D Eligibility. The Medicare Part D program is designed to provide prescription drug coverage to people who have Medicare. You get Medicare Part D eligibility when you have Medicare Part A (hospital insurance) and/or Medicare Part B (medical insurance). You don’t need to enroll in both Medicare Part A and Part B to be eligible for Medicare Part D prescription drug coverage.
In fact, people who are eligible for Medicare often defer enrolling in Medicare Part B and paying the Part B premium if they have
- Group health coverage through an employer’s or union’s group health plan (if they are still actively working),
- A retiree group health plan
- or the group health plan of a spouse.
You do need to live in the service area of your Medicare Part D prescription drug plan.
Enrollment periods for Medicare Part D plans
There are up to four different times when Medicare beneficiaries can enroll in Medicare Part D plans or change from one Medicare Part D plan to another.
- Your first opportunity to enroll in a Medicare Part D plan occurs during the Initial Enrollment Period. This is the seven-month period, starting 3 months before you turn age 65, your birthday month, and the three months after your birthday month.
- During the annual Open Enrollment Period for Medicare Advantage and Medicare Part D plans, October 15 to December 7, you can enroll in a stand-alone Medicare Prescription Drug Plan or a Medicare Advantage Prescription Drug plan or change Medicare Part D plans.
- If you enrolled in a Medicare Advantage plan (with or without Medicare Part D coverage), you have the opportunity to change to another Medicare Advantage plan or return to Medicare Part A and B and enroll in a stand-alone Medicare Part D Prescription Drug Plan. The Medicare Open Enrollment Period occurs between January 1 and March 31.
- You could qualify for a Special Enrollment Period:
- You lose creditable prescription drug coverage (that is, coverage as good as or better than Medicare) through no fault of your own
- You move to a new permanent address that is not in your current Medicare Part D plan’s service area
- Your current plan no longer offers Medicare Part D coverage
- You receive Medicaid or get Extra Help with Part D costs
- You are enrolled in a State Pharmaceutical Assistance Program (SPAP)
If you qualify for a Special Enrollment Period, the Medicare Part D plan coverage will begin the first day of the month following the month that the plan receives your completed enrollment request.
You can learn more about Medicare Part D plans that are available where you live by entering your ZIP code on this page.