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Medicare Part D Eligibility & Enrollment

5 things to know about enrolling in a Medicare prescription drug plan:

  1. There are established enrollment periods to add, change, or drop Part D coverage.
  2. First-time Part D enrollees should apply during the 7-month Initial Enrollment Period.
  3. The Annual Enrollment Period allows you to enroll, switch, or leave a Part D plan.
  4. Special Enrollment Periods may let you sign up for a Part D plan outside of the main enrollment periods.
  5. You may face a penalty for delaying Part D plan enrollment without creditable coverage.

In order to qualify for Medicare Part D coverage, you first must be enrolled in Medicare Part A and/or Part B.

Once you are eligible, you need to apply during a Part D enrollment period. If you do not sign up for a Part D plan when you are first eligible and you do not have creditable coverage, you may be required to pay a monthly late enrollment penalty once you do enroll.

If you already have a Medicare Advantage plan, you may not be eligible for a Part D plan, depending on the type of plan you are enrolled in. Some Medicare Advantage plans prevent you from enrolling in a Part D plan.

Part D enrollment periods

You must wait for an enrollment period to sign up for, make changes to, or leave a Medicare Part D plan.

Guide to Medicare Part D enrollment periods
Enrollment period Dates What you can do during this period
Initial Enrollment Period Starts 3 months before the month you turn 65
Ends 3 months after the month you turn 65
Sign up for a Medicare Part D plan
Medicare Open Enrollment Period (aka Annual Enrollment) Starts October 15
Ends December 7
- Sign up for a Medicare Part D plan
- Switch Medicare Part D plans
- Leave a Medicare Part D plan
Special Enrollment Period Depends on your personal situation Depends on your personal situation

If you need prescription drug coverage, it is important to enroll in a Part D plan during your Initial Enrollment Period (IEP) or when you are first eligible. If not, you may face a late penalty, according to Medicare.gov. If your IEP ends and there is a period of 63 days or more in a row when you do not have creditable prescription drug coverage, you may have to pay a late penalty each month for as long as you have Medicare prescription drug coverage.

Find your personal situation below to determine when you can enroll in, leave, or make changes to a Part D prescription drug plan.

Medicare.gov outlines the most common enrollment situations. If none of these situations apply to you, you may be able to qualify for a special enrollment period depending on your personal situation.

First-time Medicare Part D plan enrollees

You are 65 (or turning 65) & signing up for Medicare Parts A & B

You can join a Medicare prescription drug plan during your Initial Enrollment Period.

Your IEP is 7 months long. It starts 3 full months before the month you turn 65. It continues through the month of your 65th birthday, and then for another 3 full months.

Example: You turn 65 on June 5. Your IEP starts on March 1 (3 full months before June) and ends September 30 (3 full months after June).

If you are enrolling during your IEP, your coverage will start at the following times:

  • If you are 65: the first day of the month after you ask to join a plan
  • If you are under 65: the first day of the month you turn 65

You have Medicare Part A & are signing up for Part B during General Enrollment

You can enroll in a Medicare prescription drug plan between April 1 and June 30.

You are disabled & under 65

You can enroll in a Medicare prescription drug plan after you have been getting Social Security or Railroad Retirement Board benefits for 21 full months. After that point, you have 7 full months to enroll in a Medicare prescription drug plan.

Current Medicare Part D plan enrollees

You want to switch, make changes to, or drop your plan

You can make changes to your current Part D plan, switch plans, or drop your prescription drug coverage entirely during the annual Open Enrollment Period, which runs from October 15 to December 7 each year.

If you make changes during this time, your new coverage will begin on January 1 of the following year.

Special circumstances

In addition to the situations outlined above, you also may be able to add, change, or drop Part D plan coverage under special circumstances that qualify you for a Special Enrollment Period. The following are a few examples of situations that could qualify you for a Special Enrollment Period:

  • Change in address or living situation
  • Losing current coverage
  • Opportunity for other coverage
  • Your current Part D plan changes its contract with Medicare

Medicare.gov provides details for each Special Enrollment Period.

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*You must continue to pay your Medicare Part B premium. $0 premium plans may not be available in all areas.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or member cost-share may change on January 1 of each year.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of A Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any plan depends on contract renewal.

TZ Insurance Solutions LLC and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. This website does not contain a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call (877) 486-2048), 24 hours a day / 7 days a week or consult www.medicare.gov.

Not all plans or products are available in all markets. Additional plans may be available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Last Updated: 09/12/2017 Pending Accepted

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