Nursing home residents must go through the same application process as any other Part D applicant, though they are subject to special enrollment periods. They may also face additional difficulty in selecting a plan that contracts with pharmacies the nursing home is accustomed to working with.

Because of this, nursing home residents with cognitive and/or physical impairments could find the plan selection process even more difficult and complicated than non-nursing home residents. For this reason, it is important that family members or legal guardians help nursing home residents enroll in a plan. Nursing homes cannot and will not make the decision for residents unless an agent of the nursing home, such as a nurse or case manager, is appointed as a representative for the resident.