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FAQs on Medicare Prescription Drug Coverage

Medically Reviewed by Sarah Goodell on November 10, 2020

Medicare Part D offers insurance coverage for prescription drugs to people ages 65 and older, or those with disabilities who qualify for Medicare. This coverage is designed to help you cover the cost of your medications.

FAQs for People on Medicare and Medicaid (dual eligibles)

If My Prescription Drugs Are Covered by Medicaid, Does This Affect Me?

People who have both Medicare and Medicaid will receive their prescription drug coverage through Medicare, rather than their state Medicaid program.

In a handful of states, people who are eligible for both Medicare and Medicaid, also called ''dual eligibles,'' will have the option of signing up for ''demonstration plans'' -- Medicare-Medicaid plans that will include all Medicare and Medicaid benefits in one package, including drug coverage. If you’re interested in joining a Medicare-Medicaid Plan, visit Medicare.gov/find-a-plan to see if one is available in your area and if you qualify. Call your State Medical Assistance (Medicaid) office for more information. Visit Medicare.gov/contacts, or call 800-633-4227 and say “Medicaid” to get the phone number.

Do I Need to Sign Up for the Medicare Prescription Drug Coverage or for Extra Help?

If you have both Medicare and Medicaid, you automatically qualify for Extra Help, a program to help Medicare beneficiaries who have limited income and resources to cover the cost of their prescription drugs.

Medicare assigns you to a plan automatically if you qualify for Extra Help. It may not be the plan that best meets your needs, so your best bet is to do your homework and make an informed choice about which plan is right for you.

What If I Don't Like the Plan to Which I Am Assigned?

If you don't like the plan to which Medicare assigns you, you can change one time during each of these periods:

  • January to March
  • April to June
  • July to September
  • October 15 to December 7 (during the regular Open Enrollment period)

Show Sources

SOURCES:

Centers for Medicare & Medicaid Services: "Medicare Prescription Drug Coverage Frequently Asked Questions" and "Introducing Medicare's New Prescription Drug Coverage."

Medicare Rights Center: "Medicare Drug Coverage 101: Everything You Need to Know about the New Medicare Prescription Drug Benefit."

Medicare Rx Education Network: "What You Need to Know Now."

Social Security Administration: "What You Need to Complete the Application for Help with Medicare Prescription Drug Plan Costs."

Medicare.gov: ''Medicare & You 2017'' handbook (p. 100).

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