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.
Jul 31, 18 10:26 PM
This page answers questions about Medicare Part D, the prescription drug benefit offered by Medicare. Topics include: Who is eligible? What are some of the Costs? Factors to Consider when choosing a p…
Jul 29, 18 06:23 PM
It seems like some of the errors that have been recently made by our pharmacy techs are actually really preventable. Does the FDA do anything about
Jul 29, 18 05:24 PM
At 3:00 P.M., a pharmacist received an order to add 30 mEq/L of potassium chloride to the already running intravenous fluid for a patient. After checking
Jul 29, 18 05:12 PM
My pharmacy tells me I can get it 3 days early but then they wont fill it but 2 days early. Is the law on Xanax 2 or 3 days ?
Jul 13, 18 10:36 PM
I am looking for a tutor to help me prepare for the pharmacy technician certification exam. I live in area code 85373. Can anyone recommend a tutor?
Jul 13, 18 10:25 PM
I am to instill 3 drops into both eyes 3 times a day. Received prescription, of 3 bottles/vials, on 16 Mar 18 and need to know how to figure how long
Jul 13, 18 10:17 PM
If the name of the drug is mentioned in order to further assist the patient with getting them the medication, is this a violation of hipaa?
Jul 13, 18 09:56 PM
Recently there was a wrong-drug mistake at the pharmacy I'm employed at as a technician. One of my tech friends (who works at a different pharmacy) asked
Jun 28, 18 11:01 PM
The intern sent the following orders down: Mr. Brown, 50 mg protamine sulfate STAT. You check Mr. Brown’s chart, and he received 3,000 units of heparin.
Apr 10, 18 11:13 PM
This page covers what a Prior Authorization is and why it happens.
Apr 10, 18 10:00 PM
I know someone who is a pharmacy tech. My 10yr.olds medication was called into the pharmacy she works at. Her daughter and my daughters have an on-off
Apr 10, 18 09:26 PM
My pharmacy told my mom I didn't pick up my meds. Yes, I do have same last name but I have a different address; for all they know, that wasn't my mom.
Apr 08, 18 02:43 PM
Vitamin Resources - Information about Vitamin A, The B Vitamins, Vitamin C, and Vitamin D.
Mar 27, 18 10:20 PM
under the hippa law can a pharmacist and a pharmacy tech speak about a clients medical record amongs each other and cam pharmacy techs counsel the patient
Mar 27, 18 10:11 PM
Our pharmacy manager wants us to report any pharmacy error that happens. Why is it important to report errors? Where should we report the errors to?