Should you enroll in Medicare Part D?

If you are turning 65 and enrolling in Medicare, you still have some decisions to make.  Will you enroll in a Medicare Advantage plan?  Or will you stay with Original Medicare and get a Medicare supplement to fill the gaps in Medicare?  And will you enroll in a Part D plan for drug coverage?

In the past year I’ve met a number of people who decided not to get Part D drug coverage. These people chose to spend $142 per month for a Plan F Medicare supplement, but they don’t take any expensive prescriptions. They could afford to pay $18 – $30 per month for a Part D plan, but they chose not to.  One of these folks is a doctor!

Part D is “voluntary”, but if you don’t sign up for a plan when you first get your Medicare, you will pay a late-enrollment penalty.  The penalty grows by 1% for each month you are not enrolled in Part D.


I recently met a lady who never enrolled in Part D, but now wants a plan because her doctor says she is diabetic. Shirley is 78 years old. The drug her doctor wants her to take costs over $200 for a one-month supply.  If she had a Part D plan, she would pay a $45 co-pay for that drug.

The only way for Shirley to get into a Part D plan at this time of year was to enroll in a “special needs plan” (SNP) for people with diabetes. Shirley enrolled a Medicare Advantage SNP plan that has a $0 premium – but she is paying $27 per month because of her late-enrollment penalty for Part D.

For people who are turning 65, the advantage to enrolling in a Medicare Advantage plan is that they get Part D at no additional cost – and most Advantage plans are $0 premium.  But most of my turning-65 clients are sticking with Medicare and getting a Medicare supplement.  And most of these people are very healthy. So for them, Part D is not any easy choice. They wonder why they need to pay $18 – 30 per month for something they don’t need.

I tell people it is their choice to enroll – or not to enroll, – in Part D. But, I explain that insurance is about getting coverage for something that might happen in the future. And insurance doesn’t work if everybody waits until they need it to get it.  That’s why there is a late-enrollment penalty. Most of my clients then choose to get the lowest-cost drug plan.  However, some (like the doctor) choose to pass on Part D.




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