If you’re a Medicare beneficiary seeking help with prescription drug costs, the Pharmaceutical Assistance Program tool on Medicare.gov is a valuable resource. This tool helps you find programs that may offer financial assistance for your medications. Here’s a step-by-step guide to using it effectively:
Step 1: Access the Tool
Step 2: Enter Your Information
Step 3: Review Available Programs
The tool will display …
Manufacturer Assistance Programs: Programs offered by drug manufacturers to provide free or discounted medications.
Step 4: Understand Eligibility and Apply
Medicare Special Enrollment Period: Your Window to Sign Up Penalty-Free
The Medicare Special Enrollment Period (SEP) provides a limited window for individuals to enroll in Medicare Part B and Part D without incurring a late enrollment penalty. This opportunity is typically available to those who delayed enrollment because they had creditable employer-based health coverage, either through their own employment or that of a spouse.
Individuals have up to 8 months after losing employer coverage to enroll in Part B, and 63 days to enroll in Part D after the loss of creditable prescription drug coverage. Proper documentation—such as forms CMS-40B and CMS-L564—is required to verify prior coverage and qualify for the SEP.
CMS 40-B: CMS 40B | CMS
The CMS-40B allows beneficiaries to apply for Medicare Part B if they initially decided
to delay their enrollment.
CMS L564: CMS L564 | CMS
The CMS-L564 serves as proof that the individual had creditable coverage (such as
employer-sponsored insurance) and therefore did not need to enroll in Medicare Part B
immediately. It helps people avoid the late enrollment penalty for Part B when they eventually
apply.
