Do I Really Need a Medicare Part D Drug Plan?

If you take cheap prescription drugs – or you don't take any meds at all – Medicare drug coverage may seem unnecessary.

However, there are penalties for not having drug coverage, and you may need an unexpected prescription throughout the year.

What are the pros and cons of declining drug coverage, and when you boil it all down, do you really need a Medicare Part D drug plan? We help clients make this decision all the time, and we're here to share our recommendations.

What is Medicare Part D?

Medicare Part D helps cover the specific costs of prescription drugs. All plans cover a wide variety of prescriptions, including drugs in protected classes like cancer or HIV/AIDS meds.  

Medicare Part D coverage is tiered, so the cost of your specific prescription will be different depending on what tier your drug is on.

When you sign up for Medicare, you automatically qualify for Medicare Part D. If you have Medicare and full Medicaid coverage, you'll be auto-enrolled in a Part D drug plan (CMS.gov).

Otherwise, it's your decision whether you sign up for a plan or not.

Understanding Medicare Part D: Watch Our Helpful Video Guide

In this video, sales agent Luke Hockaday breaks down everything you need to know about Part D drug plans, including:

• The difference between standalone Part D plans and Medicare Advantage plans with drug coverage (MAPD)
• How the coverage phases work, from deductibles to initial coverage
• The $2,000 annual out-of-pocket maximum for 2025 and catastrophic coverage
• When you can enroll in Medicare prescription drug coverage

How do I get Medicare Part D?  

When you turn 65, you will have an enrollment period that allows you to sign up for Medicare. Medicare Part D can be added to your Original Medicare coverage, which includes Part A (hospital) and Part B (medical).

You can enroll in a Medicare Part D drug plan from Medicare's website, or you can get help from a licensed agent.

Here at Senior Allies, we help our clients by running a drug comparison. We can filter the plans available in your zip code based on the exact medications you take and your preferred pharmacies. The costs vary greatly depending on the drug plan's formulary and which pharmacies are in-network.

New for 2025: Even with the $2,000 annual out-of-pocket maximum now in effect, it's still important to choose the right plan that covers your specific medications. Once you reach this limit, you'll pay $0 for covered drugs for the rest of the year.

Choosing the wrong drug plan can cost you hundreds – or even thousands – more than expected, so please don't hesitate to ask for a second opinion! If you'd like a free Medicare drug plan comparison, give us a call at 833-801-7999 today!

Is Medicare Part D mandatory?  

Medicare Part D prescription drug plans are not mandatory.

Medicare Part D will have a premium that goes along with it, but even if you have cheap prescriptions or no medications at all, it can be a good idea to sign up during your enrollment period so that you don't face a penalty.

Even if you don't need a drug plan, we recommend buying the lowest premium option (some plans are as low as $7-10 per month in 2025). That way, you have some sort of drug coverage if need be, and you avoid the penalty.

If you don't like the idea of adding Medicare Part D to your original Medicare plan, you do have the option of an MAPD plan, which is a Medicare Advantage plan that includes Medicare Part D coverage.

A Medicare Advantage plan – also referred to as Medicare Part C – is private insurance, which follows the rules of traditional Medicare for those who are eligible for Medicare. MAPDs offer the coverage of Medicare Part A, B, and D bundled into one.

Many Medicare Advantage plans in 2025 offer $0 premiums while including comprehensive drug coverage.

A variety of companies offer MAPD plans, including:

• Aetna
• Cigna
• Humana

However, the specific plans available through each company will vary depending on your area.

What is a late-enrollment penalty?  

If you don’t sign up for a Part D plan, your premium goes up if you change your mind later. This is referred to as the late enrollment penalty.  

The penalty is 1% of the national base average per month. For example, if your penalty is $10 and your ideal plan is $24, you will pay $34 per month.

It might not seem like a lot, but that 1% can add up over time.

Just like all insurance, Medicare Part D helps to give you peace of mind in the event that you need help. Just because you don't require medication right now doesn't mean you never will. Similarly, if your meds are super cheap, the drug price may not always stay that way.

What if I don’t take any prescription drugs?  

Even if you don’t need the coverage right now, we recommend enrolling in the cheapest drug plan possible. This path benefits you in the case of a prescription drug emergency while avoiding the late enrollment penalty.  

If you find out you need a Part D plan with better coverage, you can always contact a trusted agent to shop around for one that works better for you during the Annual Enrollment Period (October 15-December 7).

Contact our team today to find out your options for a low-cost Medicare Part D prescription drug plan that could give you the best of both worlds.

Conclusion

If you are unsure whether or not a Medicare Part D plan is right for your circumstances, don’t be afraid to reach out. Call us for a free drug plan comparison!  

We can quickly find you the drug plans with the lowest annual cost in your county and set you on the right path!