Drug Coverage Overview

Original Medicare (Parts A and B) does not provide prescription drug coverage; however it is available to everyone with Medicare through Medicare Part D.  Part D can be purchased in conjunction with either Parts A or B through stand-alone prescription drug plans. It is also usually included in Medicare Advantage plans, including all the plans currently available in Contra Costa County.

Part D is optional but recommended. However, if you delay obtaining Part D coverage and have not had equivalent “creditable” coverage you may be subject to a late enrollment penalty if you enroll later. Therefore, it is important to make timely decisions about the coverage you wish to have.

If you do not join a plan with Part D during either your initial enrollment period or a special enrollment period, if you’re entitled to one, your coverage will revert to Original Medicare, Parts A and B, with no drug coverage.  You may then have to wait until the next open enrollment period to enroll in a plan and your coverage won’t be effective until January of the following year.

See more information about stand-alone prescription drug plans.
See more information on Medicare Advantage plans.

Choosing a Plan

Selecting the best plan for your needs can be complicated. There are many things to consider such as the plan premium, whether your particular drugs are covered, and what your copay is for each drug on a given plan.   See more information on how to choose the optimal plan.

Donut Hole

Regardless of how you get your Part D coverage, you may be subject to a coverage gap, commonly known as the donut hole. See more information on the donut hole.

Help with drug costs

Prescription drugs can be very expensive. Fortunately there are programs available to help with costs as well as other strategies that people can use to save money.

If you have limited income and resources, you may qualify for one of these assistance programs.

There are other ways to save money on your prescriptions, whether or not you have Part D and regardless of your income.

HICAP can help you explore your options. We offer one-on-one counseling at locations around the county.

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