How to apply for Prescription Advantage (State Prescription Drug Help)

Who it's for

IMPORTANT: Prescription Advantage stops accepting new applications after September 11, 2026 — apply before then; current members continue. Massachusetts' state pharmacy assistance program wraps around Medicare Part D: it caps annual out-of-pocket drug spending by income category, allows a once-a-year special enrollment to switch Part D plans, and covers one-time emergency prescriptions. No monthly premium. Income can be up to $79,800 a year for a single person ($108,200 married); under-65 members with disabilities have lower limits. Call 1-800-243-4636 (option 3).

What you'll need

• Prescription Advantage application (January 2026 edition)
• Proof of income

Where to apply

What to say when you call

“Hello, I'm calling to ask about Prescription Advantage (State Prescription Drug Help). I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need prescription advantage application (january 2026 edition), proof of income — is anything else required? What is the best next step?”

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Step by step

1. Note the deadline: new applications are only accepted through September 11, 2026. Apply before that date to enroll.
2. Gather your proof of income, such as tax returns, Social Security award letters, or other documents that show your annual income.
3. Download or request the Prescription Advantage application (January 2026 edition). You can get it by calling 1-800-243-4636 (option 3).
4. Check your eligibility before applying. People enrolled in a Medicare Savings Program are not eligible. If you are under 65 with a disability, lower income limits apply. You may also be required to apply for Extra Help before Prescription Advantage.
5. Apply online or by phone. To apply by phone, call 1-800-243-4636 (option 3). A representative can walk you through the process.
6. Submit your completed application along with your proof of income through your chosen application method.

What to expect: After submitting your application, the Executive Office of Aging & Independence will review your information. Processing times vary, so contact the agency at 1-800-243-4636 (option 3) for an estimate on when to expect a decision. If approved, Prescription Advantage wraps around your Medicare Part D coverage with no monthly premium — it caps your annual out-of-pocket drug costs based on your income category, lets you switch Part D plans once a year through a special enrollment, and covers one-time emergency prescriptions. Enrollment is renewed annually, so watch for renewal notices each year to keep your coverage active. Current members are not affected by the September 11, 2026 application deadline and may continue to renew.

Renewals

annual