Medicare contracts with private companies to offer beneficiaries prescription drug coverage. These companies offer a variety of options, with different covered prescriptions, and different costs. Beneficiaries pay a monthly premium, a yearly deductible and part of the cost of prescriptions. Those with limited income and resources may qualify for help in paying some prescription drug costs.
The Affordable Care Act required some Part D beneficiaries to also pay a monthly adjustment amount, depending on a beneficiary's or married couple's modified adjusted gross income.
The monthly Part D premium can be deducted from railroad retirement or social security benefits paid by the RRB, if the beneficiary contacts his or her Part D plan and requests that the RRB withhold Part D premiums. In January 2015, the RRB began withholding Part D income-related adjustment amounts from benefit payments.
Medicare prescription drug plans are voluntary. To enroll, individuals must have Medicare Part A, and must live in the prescription drug benefit plan's service area. Beneficiaries can join during the period that starts 3 months before Medicare coverage starts and ends 3 months after the first month of Medicare coverage. There may be a higher premium if an individual doesn't join a Medicare drug plan when first eligible, and he or she does not have other prescription drug coverage that, on average, covers at least as much as standard Medicare prescription drug coverage.
In most cases, there is no automatic enrollment to get a Medicare prescription drug plan. Individuals enrolled in Medicare Advantage Plans will generally get their prescription drug coverage through their plan.
Detailed information about Medicare prescription drug plans is available in the publication Your Guide to Medicare Prescription Drug Coverage, and the Medicare & You handbook lists Medicare Part D plans available by location. Additional resources for Medicare prescription drug plans are available on the Part D page of Medicare's website, where free personalized information is also available. The State Health Insurance Assistance Program (SHIP) and other local and community-based organizations offer personalized counseling at no cost. Beneficiaries can visit the Medicare website to find the organization nearest them.