Understanding Medicare Part D: Benefits and Coverage

Medicare is a federally funded, federally operated health insurance program for people age 65 and older as well as disabled individuals who have a work history that qualifies them to receive Social Security disability benefits. Original Medicare insurance includes Part A hospital insurance and Part B outpatient medical benefits, but does not include prescription medications. Prescription drug coverage is available through Medicare Part D plans that are offered to Medicare enrollees by private insurance companies. You may enroll in a Medicare Part D plan through the Medicare website at www.medicare.gov.

Coverage

• Medicare Part D provides prescription drug coverage for individuals already enrolled in the Medicare program. To obtain this benefit, you must join and choose a plan offered by a private, Medicare-approved Part D provider. If you do not enroll in a Medicare Part D Plan or in a specified Medicare Advantage Plan, you will pay full price when purchasing prescription medication. According to the Medicare website, you must have Medicare Part A and/or Part B to be eligible to join a Medicare Prescription Drug Plan. To obtain prescription drug coverage through a Medicare Advantage Plan, you must have Part A as well as Part B.

Monthly Premiums

• The federal government subsidizes a significant portion of the cost of Medicare Part D prescription drug plans. According to the Centers for Medicare and Medicaid Services, the current average monthly premium that beneficiaries pay for standard Part D coverage is $30 a month. Prescription co-pays typically range between $1 and $5 per covered prescription drug.

Part D Options

• A variety of insurers offer Part D plans at varying costs and levels of coverage. A Medicare beneficiary is free to choose the most appropriate plan based on his individual needs and has the option of switching providers and/or plans without a penalty once a year during the Medicare Part D open enrollment period.