Part D

Medicare has been helping America’s senior citizens to receive the quality healthcare they need at an affordable price since it was first established in 1965. But, since then, it has undergone quite a few changes and received a few upgrades. One of the most recent additions to Medicare is Part D. In effect as of January 1, 2006, Part D was part of the Medicare Prescription Drug coverage, Improvement, and Modernization Act of 2003 (MMA) and was intended to subsidize the cost of prescription drugs for beneficiaries enrolled in Medicare. In order to be eligible to enroll in Part D medicare coverage, a person must already be enrolled in Medicare Parts A & B and have joined a Prescription Drug Plan (PDP) or must be enrolled in Medicare Advantage.

There is a standard drug benefit included in Medicare Part D. This amount is set by the MMA and sets a deductible limit, after which the beneficiary must pay twenty-five percent of any drugs covered by Part D, up to a certain limit. But despite the fact that this is the standard benefit, most Part D plans opt for a copayment structure instead of coinsurance, since coinsured beneficiaries might end up paying a lot of money before they reach the limit.

Those with low incomes may think that Medicare Part D is out of their reach, but there are low-income subsidies available to make sure that every Medicare beneficiary can afford to buy the prescription drugs he or she needs in order to stay healthy. These subsidies usually take the form of having all or part of their premium paid or by seeing a reduction in the cost of the co-pay for different types of drugs that are eligible for Part D coverage. These subsidies make it possible for everyone who needs Part D to receive it.

Not every drug is covered by Medicare Part D Plans, however. There are certain drugs that are not approved by the Food and Drug Administration (FDA) and are, therefore, excluded from Part D coverage. Such drugs include drugs used for anorexia, weight loss, weight gain, fertility, erectile dysfunction, cosmetic purposes such as hair growth, symptomatic relief, barbiturates, benzodiazepines, vitamins and minerals (except for prenatal vitamins and fluoride) and drugs that require tests or monitoring services to be purchased exclusively through the drug manufacturer. So it’s important to make sure that your prescriptions are covered before you enroll in a Part D Plan.

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