The decision to get Medicare prescription drug coverage depends on how you pay for your drugs now and how you get your Medicare coverage. Most people with Medicare pay for drugs and get their Medicare in one of five ways:

  • Original Medicare only, or Original Medicare and a Medigap (‘Supplement’) Policy without drug coverage. The new Medicare drug coverage will cover half of the costs for you if you have this kind of coverage now. Enhanced options are available that provide more coverage.
  • Original Medicare and a Medigap (‘Supplement’) Policy with drug coverage. The new Medicare drug coverage will generally provide much more comprehensive coverage at a lower cost.
  • Retiree or union coverage. In most cases, people with good retiree or union coverage can continue to get it, with new financial support from Medicare.
  • Medicare Advantage Plan (like an HMO or PPO) or other Medicare Health Plan, which already include drug coverage and other extra benefits.
  • Dual coverage from Medicare with Medicaid drug coverage. These people will automatically get comprehensive prescription drug coverage from Medicare, starting on January 1.

NOTE: If you have limited income and resources, but you don’t have Medicaid, you may qualify for extra help that may pay for about 95% of your drug costs. Visit Extra Help for People with Limited Income and Resources for more information.

Because the way that Medicare drug coverage works depends on your current coverage, Medicare has specific information available to help you no matter what type of coverage you have. These resources include the CMS brochure What Medicare Prescription Drug Coverage Means to You: A Guide to Getting Started and the Medicare & You 2006 Handbook that you got in the mail this fall. You can get the brochure and other free Medicare publications by visiting or calling 1-800-MEDICARE. You should also look for and review information from your current insurer about how your current coverage will work with the Medicare prescription drug coverage.


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