Determining Medicare Part D Eligibility and When to Enroll
You are most likely eligible for Medicare Part D if you are eligible for Medicare and you are enrolled in either Medicare Part A or Medicare Part B. You can enroll in Blue MedicareRx if you permanently reside in Connecticut, Massachusetts, Rhode Island, or Vermont.
You may only enroll in one Medicare plan with drug coverage at a time. That means if you join a Part D plan but you already have a Medicare Advantage (MA) plan that includes prescription drug coverage, you will be disenrolled from the MA plan.
When you can enroll for Medicare Part D Coverage
There are three opportunities, or enrollment periods, to enroll in a Part D plan. It’s important to understand which ones may apply to you, so you always have the right coverage at the right time.
Initial Enrollment Period (IEP)
When you first become eligible for Medicare, you have a 7-month initial enrollment period. If you don’t sign up during your IEP, you may have to pay a late enrollment penalty every month for as long as you have a Part D plan.
Reasons you become eligible for your IEP include:
- You are turning 65. You have 7 months to sign up: the 3 months before your birthday, the month of your birthday, and the 3 months after your birthday.
- You have 7 months to sign up: the 3 months before your 25th month of getting disability benefits, the 25th month of getting disability benefits, and the 3 months after your 25th month of getting disability benefits.
Annual Enrollment Period (AEP)
Each year between October 15 and December 7, you have the option to enroll in Part D for the first time, or to change your current drug coverage for the next year.
Special Enrollment Period (SEP)
There are many enrollment opportunities based on a change to your location or situation, rather than the time of the year. A few examples include:
- You are enrolling into a 5 STAR Medicare Prescription Drug Plan.
- You permanently move into the Blue MedicareRx plan’s service area, which is Connecticut, Massachusetts, Rhode Island, and Vermont.
- You lose employer group prescription drug coverage.
- You are enrolled in a plan by Medicare (or your state), and you want to choose a different plan.
Other situations that are not listed here could qualify you for a special enrollment period. For questions about eligibility or to find out if your situation could qualify you for an SEP, call our dedicated team of experts today. Contact UsView additional SEP situations
- A disability for which you have been receiving Social Security Disability Insurance (SSDI) for more than 24 months.
- End-stage renal disease.
- ALS (amyotrophic lateral sclerosis), also known as Lou Gehrig’s disease, for which you are receiving Social Security Disability Insurance (SSDI) benefits.