Why do I need Medicare Part B? Why do I need Medicare Part D?

Congratulations, now that you have enrolled in Original Medicare and you’re beginning to explore your options, you’re likely to have many questions regarding coverage gaps, prescription drugs, and other Medicare-related concerns. Original Medicare Part A is hospital insurance that covers: inpatient care, skilled nursing, hospice care, and home health care. Original Medicare Part B is your primary health insurance, and it focuses on medically necessary services and preventative services, including visits to your primary care physician. Original Medicare Part B will also cover things like ambulance services, clinical research, durable medical equipment (DME), and mental health.

Original Medicare Part B is optional, but there are several reasons you need to enroll. For many Medicare beneficiaries, Medicare becomes their primary insurance after they become eligible and retire. Since Medicare is the primary health plan, without enrolling in Medicare Part B, everything that isn’t covered under Original Medicare Part A would become an out-of-pocket expense. Although it is optional, if you don’t enroll in Original Medicare Part B when you first become eligible, you may face a penalty for late enrollment unless you have creditable coverage. Having creditable coverage means that you either have other insurance or you are covered under you or your spouse’s group insurance. If you want to enroll in a Medicare Advantage plan or a Medicare Supplement plan, you must first have Original Medicare Part B to be eligible for enrollment. Medicare Advantage (Part C) is an alternative Medicare health plan option to Original Medicare Parts A and B, while Medicare Supplements work with Original Medicare Part A and Part B to fill in coverage gaps. However, both health plans require the Medicare beneficiary to have Medicare Part B and continue to pay the monthly premium.

Medicare Part D Prescription Drug Plans is an optional insurance plan for Medicare beneficiaries to provide coverage for medications. Medicare prescription drug plans (Part D) can be purchased with Original Medicare, Medicare Supplements, or specific Medicare Advantage plans that do not have prescription drug coverage built-in. Some Medicare Advantage plans include prescription drug coverage, but Original Medicare and Medicare Supplement plans do not. With the rising cost of prescription drugs, it is a good idea to ensure you are covered.

  • More than 3,400 drugs have boosted their prices in the first six months of 2019, an increase of 17% in the number of drug hikes from a year earlier, according to CBS News
  • The average price hike is 10.5% or five times the rate of inflation says, Aimee Picchi

Your premium will vary based on the plan you choose and where you live. In 2019, the average premium for Medicare Part D was $33.19. Although Medicare Part D comes with an additional premium, it will save you money in the long . 

There are several reasons and benefits of enrolling in Medicare Parts B and D. Part B provides you with your primary health insurance, enrolling when you first become eligible will save you from a lifetime of penalties. Medicare Part D is optional but provides you with drug coverage that many plans do not include. Ultimately, having Medicare Part B and D saves you money and protects you by providing necessary coverage. If you would like help evaluating your Medicare Part B and Part D options, contact the experts at Medicare Pathways.