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the medicare drug plan
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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Medicare Prescription Drug Coverage Guide

Part 6: Signing Up for a Part D Drug Plan

How to enroll and avoid hard sells

En español l Once you’ve chosen a Part D plan, it’s easy to sign up. But first make sure that it’s the plan you want and that you haven’t been talked into it by a salesperson who doesn’t have your best interests at heart.

How can I enroll?

1. On the phone by calling Medicare at 800-633-4227. If you’re hard of hearing and use TTY, call 877-486-2048 toll free.

2. Online at If you use the plan finder program to compare Part D or Medicare Advantage plans, you can enroll in the one of your choice by clicking on the “Enroll” button shown alongside the plan’s name.  You will be required to fill out an application form.

3. By contacting the plan of your choice at its website or at the phone number provided in its brochure or on Medicare’s website.

When can I enroll?

If you’re signing up with a Part D plan for the first time, you may do so in one of three different enrollment periods, depending on your circumstances:

Initial Enrollment Period (IEP): If you’re not yet in Medicare and have no other drug coverage that’s “creditable” (considered as good as Medicare’s), you can join a drug plan at any time during your seven-month initial Medicare enrollment period. This lasts from three months before to three months after the month you turn 65 (or, if you’re younger with disabilities, the month you receive your 25th Social Security disability payment). You can also use this IEP if you turned 65 while living abroad or in prison. It lasts from three months before to three months after the month of your return or release.

Special Enrollment Period (SEP): You’re entitled to an SEP in certain circumstances — for example, if you lose creditable drug coverage (such as from an employer or union), or you turned 65 before moving abroad or going to prison and now want Part D coverage on your return or release. You also get a SEP to switch to another plan if you’re already enrolled in Part D, in certain situations—for example, if you move your main residence to somewhere outside your plan’s service area; or you move into or out of a nursing home. You do not have to request an SEP in these circumstances, but can just go ahead and sign up with a plan. This kind of SEP lasts 63 days and you must be receiving Part D coverage before it expires to avoid a late penalty.

Annual Open Enrollment Period (OEP): If you miss your deadline for joining Part D during an IEP or an SEP, then you cannot enroll in a drug plan until the next OEP. This enrollment period runs from Oct. 15 to Dec. 7 each year, with coverage beginning Jan. 1. You also have to wait for an OEP if you deliberately drop creditable drug coverage that you already have (for example, from an employer or union). The OEP also serves as an annual opportunity for anybody already enrolled in Part D to switch from one plan to another.

What questions will I be asked?

Whether you enroll online, on the phone or on a written form, you must answer certain standard questions for your enrollment to be considered complete. These include:

  • Your primary address: This is the place you consider your normal home—the one used on your tax form and driver’s license—even if you live part of the year in another state. You cannot be enrolled in two Part D plans in different places, and your primary home must be within the service area of the plan you choose. If you don’t have a fixed address, the Part D plan you want may accept the address of a shelter or clinic, a PO box number or wherever you receive mail.

  • Whether you have (or had) other drug coverage: Medicare requires this information to ensure that your other benefits can be coordinated with Part D, so that the pharmacist knows what to charge you and who to bill for the balance. Also it allows the plan to confirm that you know the consequences of joining Part D, in case doing so would affect your other coverage adversely. And it shows whether you’ve been without creditable drug coverage for long enough to incur a Part D late penalty.

  • How you want to pay your premiums: You must choose one of three options: having the plan bill you directly; having the premiums deducted automatically from your Social Security check; or arranging for the premiums to be sent to the plan automatically by electronic funds transfer from your bank account. You are asked to indicate your preference on the enrollment form and generally must stick with your choice for the rest of the year.

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