Eligibility Requirements

Medicare Part D prescription drug plans are available to anyone who is eligible for Medicare in the United States, 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 and/or enrolled in Medicare Part B (for Medicare Advantage Organizations, individuals must have both Part A and Part B) may enroll in the new coverage.

Please note: The Medicare Prescription Drug Benefit is only available to members of the Medicare Advantage Prescription Drug Plan. If a beneficiary is already enrolled in a MA-PD Plan, the enrollee must receive his or her Medicare Prescription Drug Benefit through that Plan.

1. You must continue to pay your Medicare Part B premiums (and Part A, if applicable) if not otherwise paid for by Medicaid or another third-party. If you enroll in AmeriHealth 65, you must choose an AmeriHealth 65 plan with prescription drug benefits to receive Medicare Part D prescription drug coverage.
   
   
2. You must be a resident of Burlington, Camden, Cumberland, Gloucester, or Salem Counties in New Jersey.
   
   
3. You may elect an AmeriHealth 65 plan that includes (Part D) prescription drug coverage. If you join AmeriHealth 65, you must obtain your Part D benefits through this Medicare Advantage plan. If you are enrolled in a Medicare Advantage plan (like AmeriHealth 65), you may not enroll in a stand-alone Prescription Drug Plan.
   
   
4. The federal government will not allow us to accept people with End Stage Renal Disease, unless converting from AmeriHealth 65 individual or Employer Group Coverage, or if their current Medicare Advantage plan stops providing coverage in their area.

Medicare and Medicaid (Dual Eligible)

Beneficiaries who have both Medicaid and Medicare, and who are enrolled in a Medicare Savings Program will pay no premium or deductible and have no gap in coverage. Medicare and Medicaid beneficiaries will be automatically enrolled in a program with no lapse in coverage.

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, copays 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 AmeriHealth 65, 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 1-877-486-2048) 24 hours a day/7 days a week or
• your State Medicaid Office, or
• the Social Security Administration at 1-800-772-1213 (TTY/TDD 1-800-325-0778) 7 am to 7 pm, Monday through Friday

If you are already a member of AmeriHealth 65 and would like information on disenrollment, Learn more.

For additional information, read our Frequently Asked Questions about Medicare Part D.

If you live in Burlington, Camden, Cumberland, Gloucester, or Salem Counties; (New Jersey) prospective members should call 1-800-898-3492 (TTY/TDD 1-877-219-5457) 8:00 am to 8:00 pm seven days a week.