Medicare prescription drug coverage is an optional benefit.  Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to get Medicare drug coverage when you're first eligible, you'll likely pay a late enrollment penalty if you join later, unless one of these applies:

  • You have other creditable prescription drug coverage
  • You get Extra Help

Generally, you'll pay this penalty for as long as you have Medicare prescription drug coverage.

To get Medicare drug coverage, you must join a plan approved by Medicare that offers Medicare drug coverage. Each plan can vary in cost and drugs covered.

Source: https://www.medicare.gov/drug-coverage-part-d/how-to-get-drug-coverage