Beginning in January 2006, Medicare has implemented a Prescription Drug Plan that is available to any Medicare member who has Part A Medicare benefits and/or has enrolled in Medicare Part B. Part D Prescription Drug Plans are obtained in two different ways. If you retain original Medicare as primary coverage you may purchase a stand-alone Prescription Drug Plan also called a PDP. If you have opted for a Medicare Advantage Private fee- for- service plan without prescription benefits, you may also obtain a stand-alone PDP.
If you have elected to enroll into a Medicare Advantage plan that includes prescription benefits (MAPD) this plan will encompass your hospital, medical and prescription benefits into one plan. All available prescription RX plans are administered through insurance companies.
To enroll into a Part D prescription drug plan, you do so during your Initial Enrollment Period into Medicare to avoid a penalty for late enrollment. The initial enrollment period into Medicare begins the 3 months before your Medicare benefits begin, the month your benefits become effective and the three month period following. You may also sign up for a Part D plan during the Fall Annual Enrollment, which is November 15th, thru December 31st; however if outside of your initial enrollment period you may incur a penalty.
Medicare has established a standard as to what the plans most cover. Plans can have a better benefit than the standard plan, but all plans must have benefits at least equal to the standard benefit. For 2009 the Medicare Plans will have $295. deductible. After the deductible has been satisfied the plan must cover 75% of the cost of covered medications until the total drug costs reach $2700. If you reach that limit you have hit the coverage gap or "donut-hole". During this period, the insured is responsible for all drug costs until they have paid a total of $4350. out of their own pocket. If this amount has been reached, the insurance company is then required to pay 95% of the medication costs for the remainder of the year. There are many Part D Prescription Drug plans available, either as stand-alone plans or Medicare Advantage with prescription drug plans. Your medication costs will range greatly from plan to plan, so finding the plans may work best, or contacting an insurance representative may be beneficial in trying to obtain information on available plans.