Who is Eligible?

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. The program requires Medicare beneficiaries who want drug coverage to select and enroll in a private prescription drug plan approved by Medicare such as AmeriHealth Advantage.

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 their Medicare Prescription Drug Benefit through that 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)

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 Advantage, 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, seven days a week
• Your State Medicaid Office
• 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.

AmeriHealth Advantage prospective members should call 1-866-456-1695 (TTY/TDD: 1-866-456-1683) 8:00 am to 8:00 pm seven days a week for questions related to the product.

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