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6 Key Facts

1. Anyone on Medicare can get coverage regardless of income or health.

2. You are not obligated to enroll, but there may be consequences if you don't sign up when you are first eligible to do so.

3. To get Medicare drug coverage, you must select one approved private drug plan among many offering different choices. There is no single government plan.

4. Is your income limited? If you qualify for a part of the program known as "Extra Help." you'll pay very little for your medications.

5. Are your drug costs very high? You'll pay no more than 5 percent of the cost of each prescription after you've spent a certain amount of money out-of-pocket in any one year.

6. Do you have better drug coverage already? You probably won't need Medicare's Part D coverage. But it's wise to check.

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Where to Go for Help

Sources of information and assistance

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The following resources provide more information and direct assistance if you need help with Part D issues.

Centers for Medicare & Medicaid Services

The federal agency that oversees the Medicare Part D program provides several sources of information and help:

  • The “Medicare & You” handbook is sent to all Medicare beneficiaries every October and contains basic information on the Medicare program for the following year. It includes a list of Part D plans available in your area.
  • Medicare’s toll-free help line at 1-800-633-4227 is available 24 hours a day, seven days a week. (TDD users call 1-877-486-2048 toll free.) Customer representatives can answer questions in English and Spanish. For other languages, you can ask for an interpreter at no charge.
  • Medicare’s website provides general information and interactive tools to help you compare Part D plans, Medicare Advantage health plans, nursing homes and hospitals, or to find a doctor who accepts Medicare patients in your area.

Social Security Administration

The federal agency that oversees Social Security benefits also handles enrollment in Medicare and applications for Part D’s low-cost Extra Help program.

Call the SSA toll-free help line at 1-800-772-1213 (TDD users call 1-800-325-0778) or visit the Social Security website. If English isn’t your first language, you can request an interpreter when you call the help line. You can view the website in a number of languages: Click the "other languages" button at the top of the home page.

State Health Insurance Assistance Programs (SHIPs)

SHIPs offer free, expert, personal help from trained counselors on many Medicare and Medicaid issues, including Part D. They can provide counseling in your own language if you need it. SHIPs are available in every state, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands. Go to the SHIP website to find the toll-free number for your area, go to the website for the Health Assistance Partnership, or call the Eldercare Locator at 1-800-677-1116.

Medicare Rights Center

An independent, nonprofit consumer rights organization based in New York, MRC offers information and free legal help on Medicare issues (including Part D appeals) to Medicare beneficiaries throughout the country. Go to the Medicare Rights Center website or call its toll-free consumer hot line at 1-800-333-4114.

National Alliance for Hispanic Health

Among other services that promote the health of Hispanics throughout the country, NAHH provides Medicare information on its website and offers personal counseling on health issues, including Part D, on its toll-free family help line (Su Familia) at 1-866-783-2645.

National Asian Pacific Center on Aging

Among other services that promote the health of senior Asian Americans and Pacific Islanders, NAPCA provides free counseling on Part D issues. Visit the NAPCA website or call one of its help lines, according to the language you want: 1-800-336-2722 (English); 1-800-582-4218 (Chinese); 1-800-582-4259 (Korean); 1-800-582-4336 (Vietnamese).

  • Part I – How Medicare Part D Coverage Works
  • Part II – Extra Help Paying for Drugs
  • Part III – In and Out of the Doughnut Hole
  • Part IV – Deciding Whether You Need Part D
  • Part V – Choosing a Part D Drug Plan
  • Part VI – Enrolling in Medicare Part D
  • Part VII – Glossary of Terms

Patricia Barry is a senior editor at the AARP Bulletin.

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