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Anyone eligible for Medicare Part A or enrolled in Medicare Part B may also enroll in a Medicare Part D program. If you choose not to get that coverage, you can still participate in Medicare Parts A and B. Learn more about Choosing the right drug plan.
Eligible adults can choose to join a prescription drug plan run by an insurance company or a Medicare approved private company .
- If you participate in a Medicare Advantage Plan , you may get all of your Part A and Part B coverage, and prescription drug coverage. So, you may not need Part D. But if your plan doesn't include prescription coverage, you can still enroll in Part D.
- Medicare Part D is optional for anyone who who doesn't get Medicaid, SSI, or benefits from a Medicare Savings Program.
- Under Part D, not all drugs are covered but the plan pays about half your drug costs
- 1 in 3 people qualify for Extra Help with drug costs
- It protects you against ever having very high drug expenses
- It pays for brand-name and generic drugs. Starting in 2024, it will also cover prenatal vitamins prescribed by a doctor.
- You have to pay premiums, a deductible, and co-payments. But, there is extra help from the government to pay these costs for people whose income is low.
- You apply for Medicare Part D benefits directly to the prescription drug plan of your choice.
- You can choose from a selection of different plans that cover the area where you live.The plans may have different prices and drugs covered.
- You must join during the enrollment periods.
- You may have to pay the penalty if you don't join Medicare Part D when you are first eligible, but join later.
The open enrollment period for a Medicare Drug Plan is available in these situations:
- The 7-month period that begins 3 months before you turn 65 includes the month you turn 65 and ends 3 months after the month you turn 65,
- If you get Medicare due to a disability, 3 months before to 3 months after your Medicare Eligibility Date,
- During the annual enrollment period, which is between October 15 – December 31. Coverage starts the following January 1,
- Anytime, if you qualify for Extra Help,
- January 1 through March 15 of every year if you enroll in a Medicare Advantage Plan
- If you want to join or switch plans, do so as soon as possible. This way you have your membership card when your coverage begins, and you can get your prescriptions filled without delay.
Once you choose a Medicare Drug Plan, you can join by
- Completing a paper application,
- Calling the plan, or
- Enrolling on the plan’s website or the Medicare website.
You can also register by calling (800) 633-4227 (TTY users 877-486-2048).
In most cases, you must stay enrolled for the calendar year, starting the date your coverage begins. However, you can join, switch, or drop plans at other times, if you:
- Move out of the plan’s service area
- Lose additional prescription drug coverage
- Live in a nursing home or institution, or
- Are eligible for Extra Help.
Assistance and information
- Medicare website or help hotline at (800) 633-4227
- Illinois Department on Aging at (800) 252-8966
- The Center for Medicare Advocacy
- Medicare Interactive
- Medicare Rights Center
Worried about doing this on your own? You may be able to get free legal help.
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