Medicare Prescription Drug Plan Eligibility

You may be eligible to enroll for Medicare benefits beginning as early as three months before the month you turn 65 and lasting until three months after.

If you enroll during the three months before you turn 65, then your coverage will begin on the first day of your birthday month. If your birthday is the first day of the month, then your coverage will begin on the first day of the month prior to your birthday. 

If you enroll during your birthday month, or during the three months after your birthday month, coverage begins the first day of the month following your enrollment.

Medicare eligibility requirements, enrollment timing and coverage dates are different for people enrolling in Medicare due to a qualifying disability.

Get started

With prescription drug costs on the rise, you may want to consider enrolling in a Medicare Part D plan. But before you do, it's important to understand how Medicare Part D can benefit you.

Visit the Medicare Education section for a helpful Medicare Part D overview. Here, you'll learn about the four Medicare Part D drug payment stages and get tips on how to choose a plan. The PDP Plans Overview page page provides information to help you choose the right level of coverage for your needs.

Vea los beneficios y recursos en Español (View benefits and resources in Spanish)

Get help navigating the Medicare Part D experience with these tools and resources:

Look up prescription drugs

Locate a pharmacy

Enroll in a plan

See if you qualify for Extra Help

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Who can join AARP® MedicareRx Plans insured through UnitedHealthcare?  

You don't need to be an AARP member. If you're eligible for Medicare, you can enroll in one of the AARP MedicareRx Plans.

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2015 AARP MedicareRx Plans overview          

  • AARP MedicareRx Saver Plus (PDP)
    This Part D plan is ideal if you don't want to pay a lot for a drug plan, but want the peace of mind that comes with coverage. It offers a low monthly premium with a $320 deductible and low co-pays on many of the most commonly used prescription drugs
  • AARP MedicareRx Preferred (PDP)
    With predictable premiums and co-pays, this is our most popular prescription drug plan.The drug list includes nearly all generic drugs covered by Medicare Part D and most commonly used brand name drugs.

Learn more about AARP MedicareRx Plans

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Learn about Medicare Part D enrollment periods

To learn more about Medicare enrollment periods and avoid paying a late-enrollment penalty, visit the Medicare Education section to find out.

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Benefits of early enrollment

When you turn 65 or otherwise become eligible for Medicare, you can enroll in an AARP MedicareRx Plan insured through UnitedHealthcare, even if enrollment has closed for the year.

In fact, your Initial Enrollment Period begins three months prior to the month you become eligible, and ends three months afterward. You can enroll any time during this seven-month period without penalty. 

  • Enrolling early: Your coverage begins on the first day of the month you become eligible, if you enroll during the prior three months. It's a good idea to enroll at least one month prior to the month you become eligible, so you can begin receiving the benefits of a prescription drug plan as soon as you are eligible.

    If you enroll during the month you become eligible, or during the following three months, your coverage begins the first day of the month of your enrollment.

  • Enrolling late: If you don't join a plan during your Initial Enrollment Period, or you don't have creditable coverage    and decide to join later, you may pay the standard monthly premium plus a penalty of about 1% of the national average premium for each month that you delay enrollment.

    This higher premium will stay with you for as long as you are enrolled in the program.

Enroll now

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Coverage tiers for AARP MedicareRx Plans

Drugs on your formulary (drug list) are organized into different groups called tiers. Each tier has a different co-pay or co-insurance amount. If your drug is in a more expensive tier, ask your doctor if there is a drug in a lower tier that could work for you and save you money.

    Drug Tiers and Costs

Tier 1: Preferred Generic

Lowest Co-pay

This tier includes lower-cost, commonly used generic drugs. Use Tier 1 drugs for the lowest out-of-pocket costs.

Tier 2: Non-Preferred Generic

Low Co-pay

This tier includes most generic drugs. Use Tier 2 drugs, instead of Tier 3 or 4, to help reduce your out-of-pocket costs.

Tier 3: Preferred Brand

Medium Co-pay

This tier includes many common brand name drugs, called preferred brands, and some higher-cost generic drugs. Many Tier 3 drugs have lower-cost options in Tier 1 or 2. Ask your doctor if they could work for you.

Tier 4: Non-Preferred Brand 

Highest Co-pay

This tier includes non-preferred generic and non-preferred brand drugs. Many Tier 4 drugs have lower-cost options in Tier 1, 2 or 3. Ask your doctor if you can switch to one of these drugs to help reduce your out-of-pocket costs.

Tier 5: Specialty Tier

Co-insurance

This tier includes unique and/or very high-cost drugs. You pay a percentage of the total drug cost, called co-insurance.

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Savings and convenience delivered right to your mailbox

You may be able to save time and money by ordering by mail from OptumRx, your Preferred Mail Service Pharmacy2:

You could pay less and get the same medications delivered right to your mailbox:

  • Pay as low as <$0> for a three-month supply of Tier 1 medications (typically preferred generic drugs) for some plans.1
  • Contact UnitedHealthcare to find out how much you can save on Tier 2 through Tier 5 medications compared to a Non-Preferred Network Retail Pharmacy.

And, there's no shipping charge for standard delivery to U.S. addresses, including U.S. territories.

Note: If you are receiving Extra Help from Medicare, your co-pay may be lower or you may have no co-pays.

2015 Savings Benefits

1Savings apply during the initial coverage period, which begins after the payment of your required deductible (if any) and ends when the total cost of your drugs (paid by UnitedHealthcare, you and others) reaches $2,960.

2Preferred cost sharing is not available for the AARP MedicareRx Preferred (PDP) plan in the following territories: Guam, American Samoa, U. S. Virgin Islands or Northern Mariana Islands.

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See if you qualify for Extra Help

For people who meet specific income and financial resource limits, Medicare offers help paying for some or all of their Medicare Part D prescription drug plan expenses. If you qualify, you could save an average of $4,000 per year. (Savings average and income limits are based on 2015 plan coverage. Income limits will vary for Hawaii and Alaska.)2

You may qualify for additional help if you:

  • Are entitled to Medicare Part A (Hospital Insurance) and/or;
  • Are enrolled in Medicare Part B (Medical Insurance) and;
  • Live in one of the 50 states or the District of Columbia and;
  • Are single and have less than $17,235 in annual income/$13,440 in assets OR
  • Are married and have less than $23,265 in annual income/$26,860 in assets.

There is no penalty for applying for Extra Help. If you applied for Extra Help last year and did not qualify, you can reapply this year. If your assets exceed the amounts listed above, you may still be eligible for some Extra Help.

To find out about other programs, you can:

  • Call your state Medicaid agency.
  • See if your state offers a State Pharmaceutical Assistance Program.  If you qualify, you could get help paying for your monthly prescription drug premiums and/or co-pays.
  • Visit the Social Security Administration website for more information. Or call toll-free: 1-800-722-1213, between 7 a.m. and 7 p.m., Monday through Friday. TTY users, call: 1-877-486-2048.
 

 

Find Medicare Prescription Drug Plans in Your Area

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Questions?

Call UnitedHealthcare toll-free at:
1-866-699-2307
(TTY 711)

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