Medicare Part D is insurance that covers brand name and generic prescription drugs, helping people with drug costs that are not covered by existing insurance and/or Medicare. Everyone with Medicare is eligible for Medicare Part D.
There are two ways to get Medicare Part D. Medicare-eligible people may join a Medicare prescription drug plan or join a Medicare Advantage Plan or other Medicare Health Plan that offers drug coverage. Generally, plans require participants pay a monthly premium, a yearly deductible and part of the cost of prescriptions, including a copayment or coinsurance. Costs vary depending on plan.
Medicare Part D is not 100% coverage. The law that created Medicare Part D (the Medicare Prescription Drug, Improvement and Modernization Act, or MMA) establishes a standard drug benefit that Part D plans must offer in terms of the benefit structure - not in terms of the drugs that must be covered. Once the initial coverage limit is reached ($310 deductible, then 25% coinsurance drug costs up to an initial coverage limit of $2,830), the beneficiary must pay the full cost of his/her prescription drugs up until total out-of-pocket expenses reach $4,550 (excluding premiums). This coverage gap existing between the initial coverage limit and the catastrophic coverage limit is commonly called the "Donut Hole". The new Health Care law begins to address closing the coverage gaps.
Medicare Prescription Drug Coverage provides peace of mind by protecting against unexpected drug expenses. Many people need prescription drugs to stay healthy as they age. Joining Medicare Part D now protects against future problems.
