Do I need Medicare Part C or D?
Asked by: Dr. Charity Kiehn | Last update: November 8, 2025Score: 5/5 (70 votes)
Is Medicare Part D really necessary?
Is Medicare Part D required? No, Medicare Part D isn't a requirement. However, many people find that enrolling in a Part D plan is worth the investment. Your health can be unpredictable, so while you may not need many (or any) prescription drugs now, you may need them in the future.
Do I need Medicare Part C and D?
Medicare Part C is an alternative to Original Medicare. It must offer the same basic benefits as Original Medicare, but some plans also offer additional benefits, such as vision and dental care. Medicare Part D, on the other hand, is a plan that people can enroll in to receive prescription drug coverage.
Is Part D better than Part C?
Medicare Part C plans can cover both health care and prescription drugs. You can buy a Medicare Part D plan as an addition to Original Medicare. Medicare Part D plans cover only prescription drugs, not health care.
Can I go without Medicare Part D?
A person may owe a late enrollment penalty if, after their Initial Enrollment Period (when they first get Medicare Part A and/or Part B), they go without Part D or other creditable prescription drug coverage for any period of 63 or more days in a row.
Here's How Much We Paid With Medicare | Medicare Supplement vs Advantage
Is Medicare Part D mandatory for seniors?
Enrollment in Part D is generally voluntary, however, some people are required to be enrolled, and others should not enroll. People who have Medicare and who receive assistance under certain federal programs (Medicaid, Medicare Savings Programs, SSI or the Part D Low Income Subsidy) are required to enroll.
What happens if you opt out of Medicare Part D?
Important! If you call 1-800-MEDICARE and opt out of a Medicare drug plan, you could be left without any drug coverage. As long as you continue to qualify for Extra Help, you can change your mind and join a Medicare drug plan during the next available enrollment period without paying a Part D late enrollment penalty.
What are disadvantages of Medicare Part D?
Disadvantages of Medicare Part D Prescription Drug plans include: Need to anticipate your prescription drug needs for the year: Part D plans differ in the types of drugs they cover. Knowing your medical situation can help you select a plan that is right for you and covers the prescription drugs you expect to need.
Why are people leaving Medicare Advantage plans?
Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
What are the top 5 medicare supplement plans?
💬 From our Nerds: What are the top five Medicare supplement plans? "Based on NerdWallet's Medigap rubric, I picked five best Medicare Supplement Insurance companies for 2025: AARP/UnitedHealthcare, Mutual of Omaha, State Farm, Anthem and Blue Cross Blue Shield.
What is the average monthly cost of Medicare Part D?
The average estimated monthly Part D plan premium in 2025 is $46.50. Other factors can affect the cost of Part D including monthly premium, yearly deductible and copayments. High-income earners may pay a surcharge known as the “income-related monthly adjustment amount” (IRMAA).
What is the $2000 limit for Medicare Part D?
Thanks to the Inflation Reduction Act, in 2025 annual out-of-pocket costs will be capped at $2,000 for people with Medicare Part D.
Do you need Medicare Part D if you have supplemental insurance?
Actually, Medicare Part D is optional for everyone that has Medicare. It's your choice whether or not you want to enroll in a Part D drug plan. If you have other creditable drug coverage in place such as Employer group, V.A., or Tricare, then you won't be penalized for not signing up for Medicare Part D.
What are three services not covered by Medicare?
We don't cover these routine items and services: Routine or annual physical checkups (visit Medicare Wellness Visits to learn about exceptions). exams required by third parties, like insurance companies, businesses, or government agencies. Eye exams for prescribing, fitting, or changing eyeglasses.
How much money does Medicare allow you to have in the bank?
This means individuals can have any amount of assets and still qualify for a Medicare Savings Program. Assets are things that you own, such as bank accounts, cash, second homes and vehicles.
What is the 3 day rule for Medicare?
Medicare's "Three-Day Window" rule ("Rule") requires that certain hospital outpatient services and services furnished by a Part B entity (e.g., physician, Ambulatory Surgery Center (ASC)) that is "wholly owned or operated" by the hospital be included on the hospital's inpatient claim.
What happens if I refuse Medicare Part D?
If you don't sign up for a Part D plan when you are first eligible to do so, and you decide later you want to sign up, you will be required to pay a late enrollment penalty equal to 1% of the national average premium amount for every month you didn't have coverage as good as the standard Part D benefit.
What is the best medicare plan that covers everything for seniors?
Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.
Why do doctors not like Medicare Advantage Plans?
Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans is crescendoing. Some hospitals and physician practices are so fed up they're refusing to accept the plans — even big ones like those offered by UnitedHealthcare and Humana.
Why would someone not have Medicare Part D?
You may not need it if you have drug coverage from elsewhere that's “creditable” — meaning Medicare considers it to be of the same or better value than Part D. This coverage could come from an employer or union, retiree benefits, COBRA, Tricare or the Veterans Affairs health program.
Why are doctors opting out of Medicare?
Why should a direct care physician opt out of Medicare? The ONLY reason to opt out of Medicare is if you want to 1) see a Medicare patient, 2) under private contract, 3) for covered services. All three of these must be true, or it is not worth your trouble to opt out.
What is the most popular Part D drug plan?
The best Medicare Part D provider is Aetna. It has top ratings from the Centers for Medicare & Medicaid Services and affordable premiums. Other great providers include Wellcare and UnitedHealthcare.