SSA Medicare Part D Information

Medicare, a program administered by the Social Security Administration (SSA), is a form of insurance that provides health care coverage to many elderly and disabled Americans. Traditional Medicare consists of several parts: Part A covers inpatient treatment in hospitals and skilled nursing facilities, Part B covers outpatient treatment like visits to doctors and medical tests and Part D covers prescription drugs. Medicare recipients also can elect to receive Part C instead of traditional Medicare.

Eligibility

• Most people age 65 and over qualify for Medicare. People who receive Social Security disability insurance (SSDI) or supplemental security income (SSI) also qualify for Medicare after they have been eligible for benefits for two full years. Anyone who receives Medicare Parts A, B or C can sign up for Part D as well, but Medicare recipients do not have to sign up for Part D do if they do not wish to do so.

Coverage

• Medicare Part D covers a wide range of prescription medications prescribed to patients on an outpatient basis. Drugs administered to patients admitted to hospitals are covered by Medicare Part A.

Plans

• Medicare recipients can select from a number of prescription drug plans. The best plan for you depends in part on which medications you take regularly. Many pharmacists can help you choose the best plan for yourself if you ask for assistance with your selection.

Signing Up

• People who qualify for Medicare because they receive disability benefits do not have to apply for Medicare. They automatically will receive information about how to sign up for all parts of Medicare, including Part D, once they qualify. Others must apply for Medicare by contacting the SSA at 800-772-1213 or applying online.

Premiums and Co-Pays

• Medicare recipients must pay monthly premiums for Medicare Part D. Premiums vary from plan to plan. Recipients with higher incomes must pay higher premiums, while those with low incomes may qualify for assistance paying their premiums from the state in which they live. Recipients generally must cover co-payments, or co-pays, for prescription drugs as well, which vary among plans and drugs.

Medicaid

• Some people mistakenly think Medicare and Medicaid are the same thing; however, they are two different programs. Medicaid provides health care coverage to some people with low incomes. People can receive both Medicare and Medicaid if they meet the eligibility criteria for both programs.