Medicare Part D is the prescription insurance coverage program of Medicare. Brand name and generic medications are covered at pharmacies who participate in the program.
Anyone who has Medicare, regardless of prescription costs, health status, income, or resources, can get coverage. Seniors age 65 and older are eligible. Eligibility starts the third month before the month of the person’s 65th birthday.
If a person is eligible for the Medicare Part D benefit, and decides, for one reason or the other, not to enroll, there may be a penalty, for enrolling on a delayed/late basis. There are a few exceptions to this "rule", however, and it is best for the person to check with the federal goverments website (medicare.gov) in order to explore these exceptions and/or explore their options.
In order for a person to recieve the benefit from the governement under this plan, they must enroll with company that is "medicare approved."
It is similar to other insurances.
Members pay a monthly premium and have yearly deductibles.
The monthly premium is the cost you pay to join the drug plan.
The yearly deductible is the total you pay for your medications before the Part D plan begins sharing the costs.
Also, members will likely pay copayments or coinsurance on each prescription.
This is the cost of the medication that members are responsible for.
Coinsurance is a percentage of the prescription costs. Depending on which plan the member decides on, the costs will vary.
Those with limited resources and income may not have to pay a deductible or a premium for their Part D insurance.
A potential enrollee may have other insurance coverage before becoming eligible to have this prescription benefit from the goverment.
Other coverage could be from the VA (Dept of Veterans Affairs), a private insurance plan from the person's employer, a Medigap policy (Medicare coverage as a supplement), coverage from military service (TRICARE), or coverage from another source.
The “Donut Hole” is a gap in coverage in a members Part D plan.
This is what happens once the members costs accrue to an initial coverage limit.
At this point, the member is responsible for paying 100% of the cost for their prescriptions.
Some coverage in the donut hole is covered by certain plans.
Despite the existence of this coverage gap, members still pay less for their medications than they would without the Part D insurance coverage.
To wrap up this page, and to summarize, we have found answers to questions about the Part D Plan from Medicare. We've learned what it is, how it works, what a "Donut Hole" is (and we now know it is not something you order at the drive thru at Dunkin Donuts;) and we have also come to understand what other factors may be in play when trying to consider the costs for someone's coverage.
Didn't find what you were looking for? Use the box below to search this entire site.
Mar 17, 19 09:58 AM
Amoxicillin 500 mg 1cap po tid x 10/7
Mar 15, 19 11:57 PM
I got 30 Vicodin I have to take a half of pill in the morning and whole pill at night how long should my script last me
Jan 13, 19 07:44 PM
The USP797 rules state that no jewelry can be worn in the I.V. clean room setting because it wouldn't be sterile. I was wondering if silicone rings would
Jan 13, 19 05:34 PM
While approaching my pharmacy counter today my pharmacist very loudly said Nicole I found out what was wrong with your suboxane P.A.Your Dr. Office done
Jan 13, 19 04:50 PM
35 pills, 3 times a day, so it’s not even. When do I refill?
Jan 13, 19 04:26 PM
Take 1 Tablet TID, dispense #100 Refills 2 What is the days supply for insurance?
Jan 13, 19 03:57 PM
When a drug is given IV rather than orally, it eliminates the need for what? Absorption or Metabolism?
Jan 13, 19 03:37 PM
What is the difference in 0.112mg in Synthroid and 100mcg in Sintrocid from Mexico? Would this be the same dosage?
Jan 13, 19 02:17 PM
I had a prescription filled for my #120 Percocet on February 18th, how many of the pills should be in my bottle on March 16th? The directions are for me
Jan 01, 19 07:07 PM
This page discusses, "How Does Nalexone Nasal Spray Help an Overdose Victim?"
Jan 01, 19 06:34 PM
I have a script for Firocet. It says take 2 pills every 8 hours. It was written for 60 pills. How many days of supply is it?
Jan 01, 19 06:28 PM
Percocet 5/325, qty: #60, take 1 tablet by mouth 3 times a day as needed for severe pain. Is this a 20 day supply, even though it says, “as needed?” Will
Jan 01, 19 06:16 PM
How many days will #70 Suboxone Film last at a dose of 2 & 1/2 per day?
Jan 01, 19 05:53 PM
BENADRYL (diphenhydramine) 25MG TABLETS TAKE 2 TABLETS PO QID #40 NEED THE PRACTICE METHOD ON THIS BROKEN DOWN
Jan 01, 19 05:39 PM
Tresiba 200units/ml 60 units sq qd How many individual pens will be used in 30 days and how many box(es) will be needed for a 30 day supply?