Medicare Part D is perhaps the most convoluted appendage there is to the Medicare program.

When the US government rolled out Medicare Part D, the D in the alphabet stood for “drugs”. But two years since the government called for participation to the plan, only 661,000 of the seven million eligible people have participated in the plan.

You would think that most people would, at the very least, think about getting a Part D plan. But the fact is, participating in the part D plan is not as simple as you may think.

First, you need to find out to which category you belong to in Part D. There are five Part D categories based on a person’s Medicare coverage:

• Original Medicare Plan

Since the original Medicare plan does not provide coverage for prescription drugs, Part D is actually a way for you to get coverage on your prescription drugs.

You can do this by enrolling in a Medicare drug plan, a Medicare Advantage Plan or a drug plans that are specific to a state or a drug plan for low-income people.

• Medicare with Medigap Supplemental Insurance

If you have Medicare plus Medigap supplemental insurance, it is recommended that you join a Part D plan and drop your Medigap insurance. Of course, you can still keep your coverage if you want to.

• Employer-backed or Union-backed Prescription Drug Coverage

Like in the case of people who have who have Medigap insurance, you can choose to keep your current coverage and not go with a Part D plan. If you’re wondering if you should, just compare plans.

• Medicare and Medicaid

If you’re surviving on Medicare with Medicaid drug coverage, you will automatically be covered under a Part D plan. It’s either you choose a prescription drug plan or a plan will be chosen for you.

The second thing you need to think about is choosing the best plan for you. This task is daunting at best and stressful at worst. Depending on which place in the United States you’re coming from, you can be reviewing as many as 50 to 100 plans from 20 companies, which is a mix of Medicare plans and creditable plans outside of Medicare.

The Part D plans offered can be classified as HMO plans, PPO plans, Program of All-Inclusive Care for the Elderly (PACE) plans, and Medicare Private-Fee-for-Service.

The bad thing about these plans is that there is really little coverage for your prescription drugs, as each plan has a list of drugs that can be covered. It might even be that your prescription drug is not on the list at all. Then the list changes every year – so the list of drugs covered does change every year, and your co-payment too. What this means is that you might have to review your coverage year, and if you aren’t satisfied, you might have to run through the other plans being offered in your area.

In total, while Medicare Part D may have been created with the best intention, it certainly isn’t the best thing to have come off from the government.