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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 2: 'Extra Help' Paying for Prescriptions

On limited income, you may qualify for more assistance

Can anyone else apply for me?

Yes. Anyone — including a family member, friend, caregiver, legal representative, social worker or a counselor at your state health insurance assistance program (SHIP) — can complete a printed or online application and even sign it on your behalf. There is less red tape in applying for Extra Help than most assistance programs.

Do I have to fill out the application form in English?

You must fill out the application in either English or Spanish. However, you can get detailed printed instructions on how to fill out the form in these other languages: Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Russian, Spanish, Tagalog and Vietnamese. You can download these instructions from Social Security’s website. Or call Social Security at 1-800-772-1213 and ask for form SSA-1020B-INST to be mailed to you in the language you need. When calling Social Security, you can also ask for an interpreter who speaks your own language, free of charge.

What if I don’t qualify?


You may be able to get similar or better help from a state pharmacy assistance program, if there is one in your state. (Go here for details and contact information.) Most have higher income limits than Extra Help and some don’t count assets. Your state health insurance assistance program (SHIP) can tell you more. Otherwise, you can sign up for regular Medicare drug coverage.

How will I get my drugs?

By enrolling in a Medicare drug plan. If you qualify for Extra Help automatically but don’t enroll in a plan, Medicare will enroll you in one. But be aware that this plan may not meet your needs. You have the right to switch to a plan of your own choosing at any time.

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