Medicare Part D

In the United States of America, Medicare Part D is a stand-alone drug plan offered by insurers and other private companies to beneficiaries that receive their Medicare Part A and/or B benefits through the Original Medicare Plan.

Who is eligible for coverage

Anyone with Medicare Part A or Medicare Part B is eligible for Part D.

Components

There are two ways a patient may obtain Medicare Part D coverage:

• Medicare Prescription Drug Plans (PDP). These plans only cover the costs of prescription drugs and are for patients who use the Original Medicare Plan (e.g. Parts A and B) that provides fee-for-service coverage of their health care costs.
• Medicare Health Plans. These comprehensive plans cover the costs of both health care and prescription drugs. There are two types of Medicare Health Plans.
  • Medicare Advantage Plans (Medicare Part C). These plans include Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). In addition, these plans may include Private Fee-For-Service (PFFS) Plans, Medicare Medical Savings Account (MSA) Plans, or Medicare Special Needs Plans (SNP).
  • "Other" types of Medicare Health Plans such as Medicare Cost Plans, Medicare demonstrations or pilot programs, or PACE (Programs of All-inclusive Care for the Elderly).

Enrollees may switch plans during the open yearly enrollment period which November 15 through December 31 of every year.

Criticisms

Medicare Part D has been criticized for its "Byzantine complexity" and "doughnut hole" coverage.

History

Medicare Part D was enacted as the Medicare Prescription Drug, Improvement and Modernization Act of 2003." Coverage provided by the plan began January 1, 2006.