Medicare Part D Drug benefit is also known as Medicare Rx. “On January 1, 2006 Medicare initiated the Medicare Part D Prescription Drug Benefit, authorized by Congress under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, known as “MMA”” (Medicareadvocacy.org). Medicare Part D enables Medicare beneficiaries to purchase outpatient medications at retail, home infusion, mail order and long-term care pharmacies.
Medicare Part D coverage is available two different ways. Prescription Drug Plans (PDPs) are one option. “Drug coverage is added to original Medicare and some Medicare PFFS plans in a PDP” (Medicare & You 2014). There were 32 independent PDPs in Nebraska as of 2013 and 155,235 Nebraska beneficiaries enrolled in PDPs as of 2012 (Ehealthmedicare.com).
The second option is Medicare Advantage Prescription Drug Plans (MA-PDs). MA-PDs offer hospital, medical and prescription drug coverage under one policy, perhaps an HMO or PPO. “To join a Medicare Advantage plan, you must have Part A and Part B” (Medicare & You 2014).
What is covered with Medicare Part D? “Medicare Part D must cover all commercially available vaccines (like the shingles vaccine) to prevent illness, except for vaccines covered under Part B” (Medicare & You 2014). This is important in preventing illnesses in the elderly. Insulin and insulin syringes; and smoking cessation drugs are also covered under Part D. Some drugs that are excluded include: Over-the-counter drugs, weight loss drugs, cough and cold drugs; and drugs purchased in another country. Part D drugs must be approved by the Food and Drug Administration for sale in the US and available only by prescription.
There are no pre-existing condition criteria for Part D coverage...
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...nd a toll free phone number 1-800-MEDICARE (1-800-633-4227). The website and toll free phone number are listed numerous times throughout the handbook.
Works Cited
Banks, Katie. "Medicoverage - Affordable Health Insurance Quotes." Medicare Part D Insurance. Regal Benefits Insurance Services, 1 Jan. 2014. Web. 22 Apr. 2014. .
Kaiser, Henry. "Find Medicare Part D Insurance in NE." Nebraska Medicare Part D Plans. eHealthinsurance Services, 1 Jan. 2014. Web. 20 Apr. 2014. .
Meliso, Pamela. "CMA || Center for Medicare Advocacy, Inc.." Introduction to Medicare Part D. CMA, 30 June 2013. Web. 12 Apr. 2014. .
Tavenner, Marilyn. "Get Information About Prescription Drug Coverage." Medicare & You 2014. Baltimore: US Department of Health and Human Services, 2013. . Print.
MDCH (2014). Health Care Programs Eligibility. Retrieved and viewed on February 10, 2014 at http://www.michigan.gov/mdch/0,1607,7-132-2943_4860-35199--,00.html
According to Medicare’s WebPage Medicare is a Health Insurance Program for people 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). Medicare has two parts, Part A which is for basically hospital insurance. Most people do not have to pay for Part A. In addition it has a Part B, which is basically medical insurance. Most people pay a small monthly fee for Part B. Medicare first went into effect in 1966 and was originally administered by the Social Security Administration. In 1977 the control of it was switched over to the newly formed Health Care Financing Administration. Beginning in July 1973 Medicare was extended to persons under the age of 65 with certain disabling conditions. In 1988 Congress passed legislation to expand the program to cover health care costs of catastrophic illnesses.
Healthcare in the U.S. has recently been affected by implementation of the Affordable Care Act (ACA) of 2010. The intent is to create a healthca...
(II) The enacting of Medicare Part D in 2006 only helped to fuel America’s hunger for prescription medication. In 2003, President George W. Bush announced and signed the Medicare Prescription Drug, Improvement, and Modernization Act (also known as the Medicare Modernization Act, or MMA) on December 8th. The roughly $400 billion dollar measure was marketed to the American public as something that will provide care for the millions of senior citizens who, at the time, were struggling to afford prescription medication. This was the largest development of Medicare since 1965, which is when the program was initially created, and gave hope to those wishing for positive medical reform. According to title XI of the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003”, the most significant change will be the affordability of prescription drugs by implementing the importation of drugs from Canada, along with necessary safety measures, in order to lessen the cost (United States Congress, 832). For those who were in retirement homes and lacked a steady income, the affordability of drugs was often a deciding factor in the decision to seek medical attention and the idea that those individuals ceased to live simply because they lacked the funds tugged at the heartstrings of many Americans.
ACA Policies and Resolutions. (2004, October). Corrections Today, 66(6). Retrieved April 12, 2005, from EBSCOhost Web site: http://web9.epnet.com/citation.asp?tb
Ghosh, C. (2013). Affordable Care Act: Strategies to Tame the Future. Physician Executive, 39(6), 68-70.
Welcome to the Marketplace. Centers for Medicare and Medicaid Services, n.d. Web. 15 Mar. 2014.
3 Income, Poverty, and Health Insurance Coverage in the United States: 2010. U.S. Department of Commerce, U.S. Census Bureau, September 2010. (Table 4 and Table B2). http://www.census.gov/prod/2010pubs/p60-238.pdf
Medicare has four parts A, B, C, and D. Medicare Part A covers inpatient hospitalization, skilled nursing centers, hospice and some home health services. Medicare Part B covers some services not covered by Part A. Typically there is a premium charged for this coverage. Part B Covers medical supplies and outpatient visits. Medicare Part C, also known as Medicare Advantage plans are offered by private insurance companies which are in contract with Medicare. Medicare Part C provides you benefits from Part A, Part B and usually covers prescription drugs. This plan will cover most services. Last is Medicare Part D, Part D is a prescription drug program offered by private insurance companies. Part D allows drug coverage to the original Medicare plan. (Medicare.gov, 2016)
Health Services Research Foundation. (n.d.). CHSRF - Romanow Commission . Splash . Retrieved February 1, 2011, from http://www.chsrf.ca/PublicationsAndResources/PastSeries/RomanowCommission.aspx
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
Medicare and Medicaid are two of the United States largest broken systems, which must sustain themselves in order to provide care to their beneficiaries. Both Medicare and Medicaid are funding by a joint effort between the federal government and the local state government. If and when these governments choose to cut funding or reduce spending, Medicare and Medicaid take the biggest hit. Most people see these two benefits as one in the same, two benefits the government takes out of their pay check to help fund health care. While the government does deduct a sum from paychecks everywhere, Medicare and Medicaid are very two very different programs.
Gandey, Allison. “New National Drug Control Policy Includes More Prescription Monitoring.” Medscape Today. Web MD, 7 May 2010. Web. 24 Jan. 2012. .
Medicare is a federally governed insurance program, primarily serving Americans over the age of 65, younger disabled meeting specific disability criteria, and dialysis patients having permanent kidney failure. Medicare is linked to Social Security, is not income based, and is available to every American meeting the requirements of the program. Those entitled to Medicare can select Original Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) paying co-insurance and deductibles or opt to add Part C (Medicare Advantage Plans) paying a monthly premium and co-payments normally less than the out-of-pocket expenses for Original Medicare.
ObamaCare Summary: A Summary of Obama's Health Care Reform. n.d. Web. 18 03 2014. .