Am I Eligible?
NOTE: Glossary words are highlighted. Click on any glossary word to see its definition.
Who is eligible for Prescription Advantage?
You are eligible for Prescription Advantage if you are a Massachusetts resident who is either:
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65 years of age or older, OR
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under 65 years of age, working 40 hours or less a month, or not at all, and meets income and disability requirements.
If you are eligible for Medicare:
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you can join Prescription Advantage only if you enroll in a Medicare Prescription Drug Plan (PDP) or a Medicare Advantage plan with prescription drug coverage. People with "creditable" coverage that is at least as good as a Medicare Part D plan do not have to join a Part D plan. Creditable coverage is usually provided by a union or employer.
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If you have limited resources and income, you must file an application with Social Security to see if you qualify for Extra Help in paying Medicare Part D prescription drug costs. See Can I get help paying Medicare drug plan costs? for more information and an application.
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People who get SSI, full MassHealth benefits, or MassHealth Buy-In automatically qualify for Extra Help.
You cannot join Prescription Advantage if you get prescription drug benefits through MassHealth.
What are the disability requirements for those under age 65?
If you are under age 65, you can meet the disability requirements for Prescription Advantage if one of the following applies to you:
- you receive SSI or SSDI benefits
- you receive Medicare benefits
- you have a certificate of blindness from the Massachusetts Commission for the Blind
- you have a determination of disability from MassHealth
What are the income limits?
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For Massachusetts seniors age 65 or older and eligible for Medicare, gross annual household income cannot be greater than 500% of the Federal Poverty Guidelines. For a single person (or living apart from a spouse), this limit is $54,150 effective April 1, 2009. For a married couple living together, the limit is $72,850.
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For Massachusetts seniors age 65 or older who are not eligible for Medicare, there are no income limits for the Prescription Advantage Program. Anyone may join, regardless of income.
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For disabled Massachusetts residents under age 65, gross annual household income must be no greater than 188% of the Federal Poverty Guidelines. For a single person (or living apart from a spouse), this limit is $20,360 effective April 1, 2009. For a married couple living together, the limit is $27,392.
For more information, call Prescription Advantage at 1-800-AGE-INFO (1-800-243-4636), or TTY: 1-877-610-0241.
What income is counted?
Prescription Advantage counts all household income for the past year. This includes:
- Social Security income
- Pension income
- Dividends and/or interest
- Full or part-time wages
- Rental income
- Unemployment income
- Capital gains
What are the asset limits?
There are no asset limits for this program.
Can noncitizens get Prescription Advantage?
You can get Prescription Advantage if you are not a citizen. Your immigration status does not matter for this program. Noncitizens, including undocumented noncitizens, can get Prescription Advantage as long as they meet the other requirements. You do not need a Social Security number to apply.
Can I join if I am a senior in poor health?
Yes, you may join if you are in poor health. Your health status does not affect your eligibility. For seniors, there are no questions about medical conditions on the application. (For those under 65 with a disability, you must meet the disability requirements.)
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