Insignia
The badge of the Presidential Medal of Freedom is in the form of a golden star with white enamel, with a red enamel pentagon behind it; the central disc bears thirteen gold stars on a blue enamel background (taken from the Great Seal of the United States) within a golden ring. Golden American Bald Eagles with spread wings stand between the points of the star. It is worn around the neck on a blue ribbon with white edge stripes.
A special grade of the medal, known as the Presidential Medal of Freedom with Distinction, has a larger execution of the same medal design worn as a star on the left chest along with a sash over the right shoulder, with its rosette (blue with white edge, bearing the central disc of the medal at its center) resting on the left hip. When the medal With Distinction is awarded, the star may be presented depending from a neck ribbon and can be identified by its larger size than the standard medal (compare size of medals in pictures below; President Reagan's was awarded With Distinction).
Both medals may also be worn in miniature form on a ribbon on the left chest, with a silver American Bald Eagle with spread wings on the ribbon (or a golden American Bald Eagle for a medal awarded "With Distinction"). In addition, the medal is accompanied by a service ribbon for wear on military service uniform, a miniature medal pendant for wear on mess dress or civilian formal wear, and a lapel badge for wear on civilian clothes (all shown in the accompanying photograph of the full presentation set).
Read more about this topic: Presidential Medal Of Freedom