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Medicare Part D

From dKosopedia

Medicare Part D is the name given to the section of benifits covering perscription drugs under the Medicare health insurance program administered by the United States government, which covers people who are either age 65 and over, or who meet other special criteria.

Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually administered by private health insurance companies.

Recent Senate hearings on Part D prescription plans reveal a sizable coverage gap, e.g. "Donut Hole", that requires seniors to pay the full cost of drugs when the cost runs between $2250 and $5100.[1] These hearings also revealed that while the Veterans Administration has been allowed to negotiate the cost of prescriptions provided to its beneficiaries, the federal government, on behalf of Medicare, has been specifically disallowed by legislation from negotiating prices for the same medications. This cost difference has been shown to cost non-VA consumers as much as $1000 extra per month, per prescription.

In 2003 Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which President George W. Bush signed into law on December 8, 2003. Part of this legislation included fixing loop holes in the Medicare Secondary Payer Act that was enacted in 1980. By fixing the loopholes, Congress strengthened the Workers' Compensation Medicare Set-Aside Program (WCMSA) that is monitored and administered by CMS.


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Governmental links - current

Governmental links - historical

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This page was last modified 14:44, 1 February 2007 by dKosopedia user Lestatdelc. Content is available under the terms of the GNU Free Documentation License.


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