Medicare Part D is prescription drug insurance. Anyone enrolled in either Medicare Part A or Part B can sign up for it.

Medicare Part D plans are sold by private insurance companies. You usually pay a monthly premium. There are programs to help low-income individuals with the cost of the Part D premiums. If you are eligible, you may not have a premium. For more information, go to our web page about Getting Help with Part D Costs.

Do I need Medicare Part D coverage?

If you have Medicaid you must enroll in Medicare Part D. To be eligible for VPharm, the State of Vermont’s pharmacy assistance program, you must be enrolled in a Part D plan.   

If you have other prescription drug coverage, you may not need Medicare Part D. It depends on whether your current drug plan is “creditable coverage.” Creditable coverage means that your drug plan is just as good, or better, than a Part D plan.

If you have creditable coverage, then you do not need Part D coverage.

Is my current prescription insurance “creditable coverage?”

Your insurance company should have sent you a letter saying if you have creditable coverage. If you did not receive this letter, call your insurance company. The number for your insurance company is usually on the back of your ID card. Ask them if you have creditable coverage. If the answer is yes, ask them to send you a letter that says this. Keep this letter for your records.

What is the Medicare Part D penalty?

If you have Medicare Part A and/or Part B, but you do not have a Medicare Part D plan or other “creditable coverage” for prescription drugs for a continuous period of 63 days or more after the end of your initial enrollment period for Part D, then you may have to pay a late enrollment penalty in the future. The late enrollment penalty is added to your monthly Part D premium. And generally you have to pay the penalty for as long as have a Part D plan. For more information about the penalty, visit Medicare’s website.

When can I sign up for or change my Part D plan?

You can enroll in or change your plan during the Part D open enrollment period. The open enrollment period is from October 15 to December 7 every year. You should review your Part D plan options every year because premiums, coinsurance and formularies (lists of covered drugs) can change.

Help with Medicare Part D problems

See all of our Part D topics in our menu of Medicare pages.

If you are having coverage problems or need help, contact the Office of the Health Care Advocate at 1-800-917-7787. You can also ask for help by filling out our Help Request Form.