Basic Eligibility Requirements
To be eligible for Medicare Part D, you must:
- Be enrolled in Medicare Part A and/or Part B
- Live in the plan's service area
- Be a U.S. citizen or lawfully present resident
You do not need to be enrolled in both Part A and Part B. Enrollment in either Part A or Part B makes you eligible for Part D.
Part D Eligibility under Age 65
If you're under 65 and enrolled in Medicare due to disability, ESRD, or ALS, you're also eligible for Part D. Your Initial Coverage Election Period begins 3 months before your 25th month of receiving Social Security Disability Insurance (SSDI) benefits - the same month your Medicare coverage begins.
Employer Coverage and Part D
If you have prescription drug coverage through an employer or union plan, you may not need to enroll in Part D immediately. However, you must verify that your employer coverage is 'creditable' - meaning it's at least as good as standard Part D coverage. If it is, you can delay Part D enrollment without penalty.
If your employer coverage is not creditable, you should enroll in Part D during your ICEP to avoid the late enrollment penalty.
Extra Help (Low Income Subsidy)
If you have limited income and resources, you may qualify for Extra Help - a federal program that pays Part D premiums, deductibles, and copays. In 2026, individuals with income up to 150% of the federal poverty level may qualify. Extra Help enrollees are automatically enrolled in a benchmark Part D plan if they don't choose one themselves.