What is Medicare?
Medicare provides basic, affordable health coverage for beneficiaries. You cannot be denied Medicare coverage due to pre-existing conditions and coverage cannot be cancelled if you get sick. Medicare is administered by the Centers for Medicare and Medicaid Services (CMS).
You are eligible for Medicare if at least one of the following applies to you:
- People 65 or older
- People under 65 with certain disabilities
- People of any age diagnosed with End-Stage Renal Disease (ESRD)
- Eligible individuals are entitles to Original Medicare which includes Part A & Part B only.
Prescription Drug Plan (PDP or Part D) is Medicare’s optional additional insurance program that helps you pay for prescription drugs. Under these plans, prescription drug coverage is added to either “Original” Medicare or a Medicare Advantage Plan (MAPD). Prescription Drug Plans require a monthly premium.
Prescription Drug Plan Facts
- Run by Medicare-approved private insurance companies
- Helps cover the cost of prescription drugs
- May lower your prescription drug costs and help protect against higher costs in the future
- Companies may offer plans with different levels of coverage
- You must live in the service area of the drug plan you join
- Check your prescription drug needs with the plan’s coverage and drug list as well as with your cost for those drugs
You are eligible for a prescription drug plan (Part D) if at least one of following applies to you:
- First day of the month of your 65th birthday
- You have Original Medicare Part A and Part B
- You are declared eligible for Original Medicare due to disability
You can enroll, switch, or drop a Prescription Drug Plan (Part D) during these times:
- When you first become eligible for Original Medicare—you can enroll three months before and up to three months after you become eligible for Medicare Part A and Part B.
- Between October 15th – December 7th—anyone can enroll, switch, or drop a Medicare Advantage Plan with the changes taking effect the following January 1st.
- Special Enrollment Period—only applies in certain situations, ask an Insurance Specialist for more information