MEDICARE & Prescription
Drug Plans
Learn about Medicare and its associated prescription drug plans.
What is Medicare?
Medicare gives you basic, affordable health coverage as a beneficiary. You cannot be denied Medicare coverage because of pre-existing conditions, and your coverage cannot be canceled if you become sick. Medicare is managed by the Centers for Medicare and Medicaid Services (CMS).
You qualify for Medicare if any of the following applies to you:
- You are 65 or older
- You are under 65 with certain disabilities
- You have been diagnosed with End-Stage Renal Disease (ESRD) at any age
If you qualify, you receive Original Medicare, which includes Part A and Part B only.
The Prescription Drug Plan (PDP or Part D) is an optional Medicare program designed to help you pay for prescription drugs. This coverage is added to either Original Medicare or a Medicare Advantage Plan (MAPD). You pay a monthly premium for these plans.
Prescription Drug Plan Facts
These plans are run by Medicare-approved private insurance companies. They help cover your prescription drug costs and may lower what you pay, while protecting you from higher expenses in the future. Different companies offer plans with various coverage levels. You must live in the service area of the drug plan you select. Make sure to review the plan’s drug list and coverage to match your prescription needs and costs.
Eligibility
You are eligible for a prescription drug plan (Part D) if any of the following applies:
- You have reached the first day of the month when you turn 65
- You have Original Medicare Part A and Part B
- You have been declared eligible for Original Medicare due to disability
Enrollment
You can enroll in, switch, or drop a Prescription Drug Plan (Part D) during specific times:
- When you first become eligible for Original Medicare, you may enroll starting three months before and up to three months after you qualify for Medicare Part A and Part B.
- Between October 15th and December 7th each year, you can enroll, switch, or drop a Medicare Advantage Plan with changes effective the following January 1st.
- Special Enrollment Periods apply only in certain situations; contact an Insurance Specialist for details.
Call 1-800-842-7799 to speak with an Insurance Specialist.
Call 1-800-842-7799 to speak with an Insurance Specialist.
Have Questions? Find Your Answers Here!
Can Medicare help if I need care at home?
Yes, Medicare can cover some home health care services if your doctor orders them, like nursing or physical therapy.
Does Medicare cover hospital stays?
Original Medicare Part A helps pay for hospital stays, including surgery and care during your visit.
What if I want dental or vision coverage?
Original Medicare usually doesn’t cover dental, vision, or hearing. But some Medicare Advantage Plans may include these benefits.
Can I get help paying Medicare costs?
Yes, there are programs to help lower your Medicare premiums and out-of-pocket costs if you qualify based on income.
What if I miss signing up for Medicare when I’m first eligible?
You may have to pay a late enrollment penalty, but you can sign up during special enrollment periods if you have other coverage.
Does Medicare cover emergency care abroad?
Medicare usually doesn’t cover medical care outside the U.S., except in limited cases like emergencies near the border.
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