Is Part D included in Medicare?

Part D Prescription Drug coverage is part of the Medicare system, but offered by private insurers. Routine prescription drug coverage is not part of Original Medicare (Parts A & B), although some prescriptions are covered in Part A during a hospital stay and some are covered in Part B, but by no means is this coverage normal pharmacy coverage.

Although purchase of Part D is optional, if you delay when first eligible, you will incur a permanent premium penalty. The exception to this rule is not uncommon, as you can delay if you have “credible coverage” through an employer, VA, or retiree plan. Credible coverage means that the plan is certified to be at least as good as Medicare. If you are delaying coverage, you will want to retain this certification in your records to prove it when you do enroll.

Part D is available as a stand-alone plan (usually a Medigap aka Supplement is also purchased) or combined with most Part C Medicare Advantage plans. (Part C Medicare Advantage plans without Part D are most often used by VA health beneficiaries who get their prescription coverage through that program, but want access to private medical providers.) You cannot buy a Part C Medicare Advantage plan that does not include Part D and separately buy a stand-alone Part D plan; Part D must be included to get Part D.