Medicare now offers prescription drug coverage to eligible Americans. If you qualify for Medicare, it will help you pay for both brand name and generic medicines depending on your income, medical history, or current coverage.
What Is Medicare?
Medicare is the federal health insurance program for people who are 65 or older. It differs from Medicaid, which is an assistance program for low-income people of every age. In addition to serving people 65 and older, Medicare is also offered to certain younger people with disabilities and those with End-Stage Renal Disease. Medicare is broken into four different parts:
- Medicare Part A (Hospital Insurance) – Part A covers inpatient hospital stays, nursing facility care, hospice care, and some home health care services.
- Medicare Part B (Medical Insurance) – Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
- Medicare Part C (Medicare Advantage Plans) – Part C is Medicare offered through a private insurance company. Part C covers all Part A and Part B benefits, and most also offer prescription drug coverage. In addition to the Medicare A and B benefits, these Advantage plans may offer extra coverage. Medicare Advantage Plans include HMOs, PPOs, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. Learn more – and sign up – by visiting Medicare.gov.
Medicare Part D (Prescription Drug Coverage) – Medicare Part D can help you get the prescription drugs you need by adding prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered through Medicare-approved private insurers. To learn more, please check out these five additional facts about Medicare Part D.
Open Enrollment Period
You can only enroll in Medicare during certain pre-established times. Your initial enrollment period is determined based on when you become eligible for the program, and you can learn more about how the Initial Enrollment Period works by visiting Medicare.gov.
There are two annual open enrollment periods to keep in mind:
- The Medicare Open Enrollment Period occurs from October 15 – December 7.
- The Medicare Advantage Disenrollment Period occurs from January 1 – February 14.
Medicare offers a range of programs, and it’s important to keep your medication lists and other criteria in mind when reviewing your options – this way, you’ll choose the plan that works best for your specific needs. Visit Medicare.gov to browse plans and sign up for coverage.
Using Medicare to Help Pay for Prescriptions
Medicare can help you pay for your prescription medications. Get started with three simple steps:
- Find out if you're eligible
- Locate a Medicare insurance plan that fits your needs
- Apply for coverage
Low-Income Subsidy (“Extra Help”)
Medicare offers extra help to qualifying low-income patients who participate in Medicare Part D. Qualifying applicants are eligible for additional prescription drug assistance. Visit the Social Security Administration website to find out if you meet the Low-Income Subsidy requirements and apply for extra help.
The Partnership for Prescription Assistance has created a worksheet you can use to help prepare your Medicare Prescription Drug Plan application. Download the application worksheet.