Individuals must first be enrolled in or qualified for Original Medicare (Part A and Part B) to be eligible for Medicare Part D drug insurance. There is no doubt that prescription drug costs can become expensive, and Medicare Part D serves to lower the price of medications enabling the beneficiaries to maintain consistency in their healthcare and prescriptions. It is important to understand the helpful information regarding the requirements for Medicare Part D Eligibility before making any decisions on this particular plan. We also encourage our readers to speak with a licensed insurance agent for additional information and support.

What Are the Qualifications and Who is Eligible for Medicare Part D?

Since Medicare Part D is contingent upon being enrolled in Original Medicare it’s necessary to briefly address those eligibility requirements which include the following:

  • Being at least 65 years old.
  • A U.S. citizen or be a resident of the U.S. for a minimum of 5 years.
  • Younger people that have disabilities and people with diseases such as ESRD and ALS.
  • Combination mixes of Original Medicare Parts A, Part B, and Part D along with Medigap and Medicaid are acceptable.
  • Individuals enrolled in Medicare Advantage with prescription coverage are not eligible since it would be considered redundant.

How Does Medicare Advantage Effect Eligibility of Medicare Part D?

Medicare Part D is considered a supplement to Original Medicare whereas, when someone selects Medicare Advantage coverage it replaces Original Medicare’s hospital and medical insurance and may supply more robust coverage with coverage options extending to:

  • Dental
  • Vision
  • Hearing
  • Prescription

Medicare Part D is typically selected for its prescription coverage that is added to the individual’s existing Original Medicare coverage. Medicare Advantage plans will typically have a prescription coverage but if for whatever reason the Advantage plan does not have prescription coverage, Part D may be added.