Medicare - Mistake Not Enrolling in a Part D Plan

Medicare - Mistake Not Enrolling in a Part D Plan

April 11, 2022


I purchased a Medigap plan, but I’m healthy and do not take any medications.  Can I skip enrolling in a Part D plan?

My Response:

Technically, you do not have to enroll in Medicare Part D.  However, unless you have creditable drug coverage, which I am assuming you do not since you purchased a Medigap plan, it could be a costly mistake not to.  Here are several reasons why.

There is a late enrollment penalty for Medicare Part D should you not enroll when you are first eligible and decide later to enroll.  The penalty is cumulative.  The penalty grows by 1% of the national base drug plan premium for each month you do not enroll.  If you wait three years, that would be a 36% penalty on top of your Prescription Drug Plan (PDP) premium which will continue for as long as you remain enrolled in Part D.  In other words, for life.

Medicare Part D offers catastrophic drug coverage.  It greatly reduces the cost of your medication should you pass a certain amount of covered drug spending in a calendar year.  With some medications costing thousands or tens of thousands of dollars per month, it can prevent you from facing medical bankruptcy.

You can purchase an inexpensive Part D Prescription Drug Plan for under $10 per month which will provide that catastrophic coverage in the event you need it.

The NYS Elderly Pharmaceutical Insurance Coverage (EPIC) program only works if you have a Part D plan.  EPIC helps qualified seniors with their drug costs.  To qualify, you need to have an annual income of less than $75,000 if single and less than $100,000 if married. 

Key Take-away: The low premium, the catastrophic risk coverage, the late enrollment penalty and for some seniors, the additional benefit associated with EPIC make a Medicare Part D Prescription Drug Plan well worth it when weighed against the risk of not having it.

As always, feel free to contact my office for additional information.  My Medicare advice is free to you.