Am I Eligible for Medicare Part D?

Eligibility for Medicare Part D is not open to everyone. You must meet certain criteria to enroll in a Medicare Part D plan. Specifically, you must fall into one of the following categories:

  • You are age 65 or older
  • You have a qualifying disability for which you have been receiving Social Security Disability Insurance (SSDI) for more than 24 months1
  • You have been diagnosed with End-Stage Renal Disease (permanent kidney failure requiring a kidney transplant or dialysis)
  • You are entitled to Medicare Part A and/or enrolled in Medicare Part B

Who Should Enroll in Medicare Part D?

When you are eligible for Medicare, you are eligible for Medicare Part D. You are encouraged to enroll in a Medicare prescription drug plan when you are eligible unless you have other creditable prescription drug coverage. If you don’t enroll during your Initial Enrollment Period2, Medicare will add a Part D Late Enrollment Penalty to your monthly Part D premium. You should enroll in a Medicare prescription drug plan if:

  • You use prescription drugs on a regular basis
  • You think you may need prescription drugs in the future
  • You do not have creditable prescription drug coverage (as good as Medicare’s)
  • You are worried about increasing prescription drug costs
  • You are having trouble paying for your prescription drugs

Medicare Part D offers programs that may help pay for your prescription drug expenses if you qualify. By enrolling in a prescription drug plan, your drug costs can be lower. If you are eligible for Medicare, you should seriously consider a prescription drug plan and learn when to enroll today.

1During the 7-month period that starts 3 months before your 25th month of getting Social Security or Railroad Retirement Board disability benefits and ends 3 months after your 25th month of getting disability benefits. Your coverage will begin the first day of the month after you ask to join a plan. If you join during one of the 3 months before you first get Medicare, your coverage will begin the first day of your 25th month of entitlement to disability payments.
2Your IEP is the 7-month period that begins three months before your 65th birthday, includes your birthday month and ends three months afterward. There is an exception if your birthday falls on the first of any month, your 7-month IEP begins and ends one month sooner. For example, if your birthday is July 1, your 7-month IEP is the same as if you were born in June— beginning in March and ending in September.