Hardly a day goes by where people don’t ask us, “do I really need to have a prescription drug plan?” Usually, their reasoning is something like this: “Well, you know, I don't even take medications,” or “My medications are all generic and they're very cheap so why do I need to have a drug plan?”

These are great questions that we would love to answer for you (spoiler alert, yes, everyone needs a drug plan - more on why below). To help explain why everyone needs a drug plan I would like to share the four main reasons why you need a prescription drug plan (plus give you a little insight into what can happen when you don’t have a prescription drug plan).

Why You Need a Prescription Drug Plan

There are four main reasons why you need to get on a prescription drug plan. Let’s take a look at each of them. 

Reason #1 

The first reason why you need to be on a prescription drug plan is that things change unexpectedly. You may be healthy today, but that could change drastically in three or six months. You have no idea what the future holds (none of us does). Unfortunately, you cannot pick up a drug plan any time you like (see reason #4 below for more details). 

Reason #2

The second reason you need a prescription drug plan is for the simple fact that many medications are not cheap. In fact, research shows that the average person will spend more money on medications than anything else within their health care. 

I know two ladies right now who are being treated for cancer with self-administered chemotherapy pills. These pills cost $7,000 every single month. Thankfully, they both have a drug plan and only pay a fraction of the cost. If a similar situation unexpectedly happened to you and you didn’t have a prescription drug plan, you’d be out of pocket for the full amount.

Reason #3

Thirdly, you need a prescription drug plan because of the penalties you accrue for not having one. What does this mean? If you don’t get a drug plan when you turn 65 (or whenever you retire and go on Medicare), Medicare adds a one percent penalty for every month you don't have a drug plan. And this penalty is for life, it never goes away. 

So if you went on Medicare at 65, but didn’t get a drug plan until you were 67 (24 months later), you would have a 24 percent penalty added to your prescription drug plan cost. And again, you’d pay this penalty for the rest of your life. 

Reason #4

The fourth and final reason you need to have a prescription drug plan (regardless of whether or not you take medication right now) is because there’s a very limited window of time where you can actually pick a drug plan. 

Many people think they can go without a drug plan until they need one. They assume that if they get sick and need expensive medication, they can simply call up Medicare and get enrolled in a drug plan. Unfortunately, this is not how it works. 

Medicare only allows you to pick a drug plan at certain times of the year. So let’s say it’s January 1, and you're not on a drug plan. February or March rolls around, and you get diagnosed with something serious. Can you get on a drug plan now? The answer is no. You’re in what is called a lock-in period, meaning whatever plan you have, (or if you don’t have one) that’s the one you have to keep. So whether you desperately need a prescription drug plan or not, you’ll have to wait until October 15 comes around (Medicare’s annual open enrollment period is from October 15 to December 7) to get a drug plan. Even then, once you enroll into a drug plan it won't begin coverage until January 1 of the next year. 

So, Do You Need a Prescription Drug Plan?

“Yes!” Things can change quickly, and although you may not take medications right now, you have no idea what the future might hold. Further, medications are not typically cheap, and you don’t want to be stuck paying those bills out of your own pocket. Also, you need to get on a prescription drug plan simply because of the penalties Medicare adds for every month you go without one. Finally, it’s essential to get on a prescription drug plan when you turn 65 (or retire) since there’s only a limited window of time when you can enroll. If you miss this window, you’ll be stuck without a prescription drug plan until next year’s enrollment period begins.  

So if you’re going on Medicare this year, make the right choice and get on a prescription drug plan. If you have more questions about enrolling in Medicare or need more information about prescription drug plans we invite you to click here to watch our full Medicare Workshop.  You can also schedule a one-on-one call with one of our certified Medicare School Guides. Our Guides can help answer any questions you have and can even enroll you into Medicare over the phone. Click here to schedule an appointment.  



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MedicareSchool.com started in 2009 to provide an unbiased and education-focused service to individuals approaching Medicare enrollment. Since then, MedicareSchool.com has helped over 100,000 people find and enroll in the best Medicare plans that fit their budget.