Who is Eligible?

Medicare Part D prescription drug plans are available to anyone who is eligible for Medicare Part A benefits, or who is enrolled in Medicare Part B, regardless of age, income, or health conditions. You must live in the service area of the plan you join. Participation is voluntary.

Medicare Recipients

Anyone who is entitled to Medicare Part A or who is enrolled in Medicare Part B (for Medicare Advantage Organizations, individuals must have both Part A and Part B) may enroll in a Medicare Part D prescription drug plan. The program requires Medicare beneficiaries who want drug coverage to select and enroll in a private prescription drug plan approved by Medicare, such as PerformRx Prescription Drug Plan (PDP).

Please note: In most Medicare Advantage Plans, if your plan offers Medicare prescription drug coverage and you want drug coverage, you must get it from your plan. In these cases, if you join a stand-alone Medicare Prescription Drug Plan, you will be disenrolled from your Medicare Advantage Plan. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party.

Medicare and Medicaid (Dual Eligible)

Dual-Eligible Medicare and Medicaid beneficiaries who do not choose a Medicare Part D Plan are automatically enrolled into a Medicare Part D prescription drug program. This automatic enrollment provision also applies to Dual-Eligibles who are enrolled in Medicare MSA plans or other plans that do not offer a drug benefit.

Low Income Subsidies

People with limited incomes and resources may receive full prescription drug coverage at little or no cost. Eligibility depends on income (money received from retirement benefits and other reported income) and in some cases, assets. Depending on level of need, premiums, co-pays and deductibles may be reduced or eliminated and the coverage gap may be eliminated. If you qualify for extra help with your Medicare Prescription Drug Plan costs, your premium and drug costs will be lower. When you join PerformRx PDP, Medicare will tell us how much extra help you are getting. Then, we will let you know the amount you will pay.

Beneficiaries interested in qualifying for extra help with Medicare Prescription Drug Plan costs should call:

• 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048 (24 hours a day/ 7 days a week),
• Your State Medicaid Office, or
• The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778.