Learning About Medicare's Prescription Drug Coverage
Medicare prescription drug coverage is coverage for brand-name and generic prescriptions drugs. Called "Medicare Part D", this coverage gives protection for those who have very high drug costs or from unexpected prescription drug bills in the future.Everyone who has Medicare is eligible for this coverage. You will not be excluded because of your income and resources, health status, or current prescription expenses.
There are special periods in which you must sign-up for this coverage. If you don't sign up when you are first eligible, you may pay a penalty. There are two ways to get a Medicare prescription plan: you can join a Medicare prescription drug plan, which covers prescription help only; or you can join a Medicare Advantage Plan or other Medicare Health Plan that offers drug coverage along with health care coverage. (For other Medicare topics, see our home page The Medicare Project - home)
As in most government programs, there are always details, exceptions and variances which could differ from the basic information we provided above. Do not use this information as legal or precise advice. Search carefully through the web pages and brochures listed in our directory below for more detailed information. You can see the U.S. Centers for Medicare & Medicaid Services - www.medicare.gov for the official US government Medicare policies and regulations.
brochure or publication:
Medicare Part D 2008 Data Spotlight: Premiums October 2007
source: Kaiser Family Foundation
file size: 2 pg. languages: English
from the brochure: "...This data spotlight examines PDP premiums in 2008 and trends since 2006. The 2008 analysis is based on data from the Centers for Medicare and Medicaid Services (CMS) on 1,824 PDPs offered around the nation, excluding territories...
As in previous years, PDP premiums vary widely for 2008, with higher-premium plans typically offering more generous benefits. Across all 50 states and D.C., PDP premiums range from $9.80 to $107.50 per month. Overall, 40 percent of plans are priced below $30 per month, but roughly the same share (38 percent) have premiums of $40 or more..."
more from Kaiser Family Foundation:
web page:
The Medicare Prescription Drug Benefit - An Updated Fact Sheet
languages: English
from the web page: "This updated fact sheet includes the latest information and data about the Medicare Drug Benefit, including 2008 plan information, a breakdown of the standard benefit, updates on additional low-income assistance, and the latest available enrollment data.
web page:
Prescription Drug Coverage and Seniors: Findings from a 2003 National Survey
languages: English
from the web page: "This national survey of 17,685 seniors captures detailed information about their prescription drug use, coverage and experiences. It also includes state-specific comparative data for seniors in 12 states -- California, Colorado, Florida, Illinois, Louisiana, Michigan, New York, Ohio, Pennsylvania, Texas, Tennessee and Washington... "
web page:
Prescription Drug Costs and Medicare
languages: English
from the web page: "...offers general information about the Medicare drug benefit, advice for determining if the Medicare drug benefit is right for you, key considerations for selecting a Medicare drug plan that best meets your needs, and information about extra financial assistance with drug costs available for those with limited incomes..."
web site:
Consumer Reports Best Buy Drugs
languages: English
"...provides consumers and doctors with information to help them make more cost-effective prescription drug choices based on a drug's safety, effectiveness and price... "
web page:
Medicare Prescription Drug Plan Finder
source:medicare.gov
languages: English date:August 2006
from the web page: "Find & Compare Plans that Cover Drugs...Search includes personalized information about: Medicare Prescription Drug Plans; Medicare Health Plans (that cover drugs)..."
also from medicare.gov:
Medicare brochure or publication:
Your Medicare Rights and Protections
44pp languages: English
our comments: Fairly detailed explanations and descriptions about your Medicare rights and protections.
web page:
Medicare Prescription Drug Coverage
source:AARP
languages: English
AARP's central resource for the Medicare Prescription Drug Coverage.
more from AARP:
web page:
How Much Will Medicare Prescription Drug Coverage Cost and What Will I Get in Return?
languages: English
from the web page: " The standard Medicare drug benefit offers insurance that will pay some of your drug expenses and will protect you against very high costs. If you have additional drug coverage – from an employer or a state pharmacy assistance program, for example – this will reduce your out-of-pocket expenses more... During a calendar year, here's how the standard plan works: ...."
web page:
The AARP Guide to Understanding Medicare Drug Coverage
languages: English
from the web page: "November 15 marks the beginning of Medicare enrollment season. While Medicare is intended to help those in need, the rules and processes around the drug plans can be especially confusing and frustrating, whether you are enrolling yourself, or your loved ones. Our guide can help you navigate your way..."
brochure:
November 2007 - Buyer Beware: Higher Costs, More Confusion for the 2008 Part D Enrollment Season
source:Families USA
file size:12 pg. languages: English date:November 2006
from the brochure: "..The Annual Enrollment Period for the Medicare Part D drug program begins on November 15, 2007, and runs until December 31, 2007. During this period, all Medicare beneficiaries in a Part D prescription drug plan will have the opportunity to switch plans. Many Part D plans are making changes for 2008 that will result in significantly higher costs for beneficiaries. This makes it especially important for all Part D enrollees to examine their plans carefully to see if the plans will continue to suit their needs..."
more from Families USA:
web page:
Medicare Drug Coverage Center - Information on Medicare Part D
languages: English
from the web page: "This center has resources from Families USA and other groups that explain how Part D works, as well as links to resources that can help beneficiaries make the right choices about their drug coverage, particularly low-income beneficiaries. We also have have an archive of materials on the history of the legislation and other background information..."
What drugs do Medicare Drug Plans Cover?
source: U.S. Administration on Aging (U.S. Health & Human Services)
4 pages; languages: English
from the brochure: "Medicare drug plans must cover prescription drugs in all prescribed categories and classes but Medicare drug plans don’t have to cover every drug. Certain drugs may be excluded*. Although your drug plan may not have a specific drug on their list of covered drugs (formulary), a similar drug that is safe and effective should be available. This may be in the form of a therapeutic alternative or generic drug... "
Note: For Medicare Advantage plans, which combine both prescription and health care coverage, please see our page Prescription plus Medical Coverage -Medicare Advantage Plans.
Web pages and brochures from government and non-commercial sites about Medicare Prescription Drug Plans:
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brochure: Medicare Prescription Drug Coverage Basics source: Centers for Medicare & Medicaid Services (CMS), a Federal agency within the U.S. Department of Health and Human Services file size: 2 pg. languages: English our comments: Brief questions and answers -usually a few paragraphs- about the Medicare prescription drug plan. Subjects include "When can people with Medicare join the Medicare prescription drug plans?", "Is there additional assistance for those who need it?", "Do Medicare prescription drug plans work with all types of Medicare health plans?" and others. also from Centers for Medicare & Medicaid Services (CMS): brochure: Five Simple Steps: "A National Day of Conversation - Friends and Family First" 15 pages; languages: English from the brochure: "...This holiday season is a great time to pull up a chair and have a conversation with a friend or loved one about the new Medicare Prescription Drug Coverage. The day after Thanksgiving... will be a national day of conversation about the new Medicare prescription drug coverage. Use these five simple steps to help guide you through your conversation..." |
|
Medicare Part D 2008 Data Spotlight: Premiums October 2007
source: Kaiser Family Foundation
file size: 2 pg. languages: English
from the brochure: "...This data spotlight examines PDP premiums in 2008 and trends since 2006. The 2008 analysis is based on data from the Centers for Medicare and Medicaid Services (CMS) on 1,824 PDPs offered around the nation, excluding territories...
As in previous years, PDP premiums vary widely for 2008, with higher-premium plans typically offering more generous benefits. Across all 50 states and D.C., PDP premiums range from $9.80 to $107.50 per month. Overall, 40 percent of plans are priced below $30 per month, but roughly the same share (38 percent) have premiums of $40 or more..."
more from Kaiser Family Foundation:
web page:
The Medicare Prescription Drug Benefit - An Updated Fact Sheet
languages: English
from the web page: "This updated fact sheet includes the latest information and data about the Medicare Drug Benefit, including 2008 plan information, a breakdown of the standard benefit, updates on additional low-income assistance, and the latest available enrollment data.
web page:
Prescription Drug Coverage and Seniors: Findings from a 2003 National Survey
languages: English
from the web page: "This national survey of 17,685 seniors captures detailed information about their prescription drug use, coverage and experiences. It also includes state-specific comparative data for seniors in 12 states -- California, Colorado, Florida, Illinois, Louisiana, Michigan, New York, Ohio, Pennsylvania, Texas, Tennessee and Washington... "
web page:
Prescription Drug Costs and Medicare
languages: English
from the web page: "...offers general information about the Medicare drug benefit, advice for determining if the Medicare drug benefit is right for you, key considerations for selecting a Medicare drug plan that best meets your needs, and information about extra financial assistance with drug costs available for those with limited incomes..."
Consumer Reports Best Buy Drugs
languages: English
"...provides consumers and doctors with information to help them make more cost-effective prescription drug choices based on a drug's safety, effectiveness and price... "
Medicare Prescription Drug Plan Finder
source:medicare.gov
languages: English date:August 2006
from the web page: "Find & Compare Plans that Cover Drugs...Search includes personalized information about: Medicare Prescription Drug Plans; Medicare Health Plans (that cover drugs)..."
also from medicare.gov:
Medicare brochure or publication:
Your Medicare Rights and Protections
44pp languages: English
our comments: Fairly detailed explanations and descriptions about your Medicare rights and protections.
Medicare Prescription Drug Coverage
source:AARP
languages: English
AARP's central resource for the Medicare Prescription Drug Coverage.
more from AARP:
web page:
How Much Will Medicare Prescription Drug Coverage Cost and What Will I Get in Return?
languages: English
from the web page: " The standard Medicare drug benefit offers insurance that will pay some of your drug expenses and will protect you against very high costs. If you have additional drug coverage – from an employer or a state pharmacy assistance program, for example – this will reduce your out-of-pocket expenses more... During a calendar year, here's how the standard plan works: ...."
web page:
The AARP Guide to Understanding Medicare Drug Coverage
languages: English
from the web page: "November 15 marks the beginning of Medicare enrollment season. While Medicare is intended to help those in need, the rules and processes around the drug plans can be especially confusing and frustrating, whether you are enrolling yourself, or your loved ones. Our guide can help you navigate your way..."
November 2007 - Buyer Beware: Higher Costs, More Confusion for the 2008 Part D Enrollment Season
source:Families USA
file size:12 pg. languages: English date:November 2006
from the brochure: "..The Annual Enrollment Period for the Medicare Part D drug program begins on November 15, 2007, and runs until December 31, 2007. During this period, all Medicare beneficiaries in a Part D prescription drug plan will have the opportunity to switch plans. Many Part D plans are making changes for 2008 that will result in significantly higher costs for beneficiaries. This makes it especially important for all Part D enrollees to examine their plans carefully to see if the plans will continue to suit their needs..."
more from Families USA:
web page:
Medicare Drug Coverage Center - Information on Medicare Part D
languages: English
from the web page: "This center has resources from Families USA and other groups that explain how Part D works, as well as links to resources that can help beneficiaries make the right choices about their drug coverage, particularly low-income beneficiaries. We also have have an archive of materials on the history of the legislation and other background information..."
web page:
Why should I consider switching my Medicare plan for 2008?
source:My Medicare Matters
languages: English
from the web page:"Here are some questions to ask yourself in deciding whether you should switch your plan:..."
also from My Medicare Matters:
web page:
7 Simple Steps
languages: English
"7 Simple Steps is an introduction to the Medicare prescription drug coverage, also known as Part D..."
brochure or publication:
The Medicare Drug Benefit: Straight Answers to the Toughest Questions
source:The Century Foundation
file size:19 pg. languages: English
from the brochure: "In November 2003, Congress narrowly passed the Medicare Modernization Act (MMA), legislation adding outpatient prescription drug coverage to Medicare, the federal health insurance program for older and disabled Americans. That new benefit, known as Medicare Part D... but many questions remain about how it will work. This brief provides answers—to the extent they are available—to the most common questions.
web page:
5 Questions to Help You Get Ready for the Drug Benefit
source:familydoctor.org- American Academy of Family Physicians
languages: English
from the web pag: "Medicare has added coverage for prescription medicines. This means that people who have Medicare Part A (hospital insurance) or Medicare Part B (medical insurance) are able to get insurance to pay for part of their prescription drugs. Medicare is working with insurance companies to offer this benefit. It is available no matter what your income, illnesses, or drug costs....
also from familydoctor.org:
web page:
Prescriptions and Insurance Plans
languages: English
from the web pag: "Getting a prescription filled is usually easy. But because of the high cost of prescription medicines, most insurance companies and employers are trying to control drug costs. Some of the things they are doing make getting a prescription more complicated for you and your doctor, and some of the terms they use can be confusing...."
brochure or publication:
Medicare Part D – The Drug Benefit - Time for 2008 Enrollment – Our Advice
source:Consumers Union
file size:4 pg. languages: English
from the brochure: "...We advise all Medicare beneficiaries now enrolled in a Medicare Advantage (HMO or PPO) or stand-alone Part D plan to carefully assess their prescription drug needs and satisfaction with their current plan and coverage, and to evaluate whether a switch in plans may be warranted..."
also from Consumers Union:
Web page:
Advice for 2008 Medicare Part D Drug Coverage
languages: English
from the web page: "...With dozens of plans to choose from, and the potential to fall into the dreaded ‘doughnut hole’ coverage gap, the decision can be confusing....."
web page:
Choose Your Plan: Make An Informed Decision
source:Making the Most of Your Pharmacy Benefit Plan (National Pharmaceutical Council)
languages: English
from the web pag: "...If you are enrolled in a Medicare Advantage plan, your only option for prescription coverage will be through your Medicare Advantage plan. However, if you are not enrolled in a Medicare Advantage plan, you may have a number of different Medicare Prescription Drug Plans (PDPs) to choose from.....
Medicare Web Page:
ANATOMY OF A PART D PLAN
source:Cornell University Resource Education for Medicare Part D
languages: English
fromthe web page: "...Medicare Part D legislation requires that all insurance companies which offer Part D prescription drug insurance must follow certain rules in designing the offerings of a plan... Companies must offer a plan that meets the requirements of a basic benefit before offering a plan with enhanced benefits. The basic benefit can meet one of three different plan designs...."
also from Cornell University Resource Education for Medicare Part D:
Medicare brochure or publication:
Understanding the Coverage Zones
file size: 9 pages; languages: English
description from brochure: "...A standard benefit Part D plan design has four coverage zones. The first zone of coverage is the Deductible, which in 2008 is $275...."
web page:
Health Plan Report Card
source:National Committee for Quality Assurance
languages: English
from the web pag: "...NCQA's Health Plan Report Card can help you answer questions about health plans that would be difficult or impossible to answer on your own-Does this health plan provide good customer service? Will I have access to care I need? Does the plan check doctors' qualifications? If I get sick, which plan will take better care of me?...
web page:
Use this chart to compare your Medicare options
source:Medicare Rights Center
languages: English
from the web pag: "...The chart below compares the benefits of Original Medicare to the most common types of Medicare private health plans. Click on a question, the type of Medicare plan, or each light for more details....
web page:
2008 SUMMARY OF MEDICARE PRESCRIPTION DRUG PLANS (PDPs) & MEDICARE ADVANTAGE PRESCRIPTION DRUGS PLANS (MA-PDs)
source:CENTER FOR MEDICARE ADVOCACY, INC.
languages: English
from the brochure: "Medicare Part D drug coverage is provided by a variety of private plans, not by the Medicare program itself. This is different from the way Parts A and B work. Also unlike Medicare Parts A and B, people have to take action to enroll in Part D. They can choose a separate Prescription Drug Plan (PDP) and stay in the traditional Part A and B Medicare program, or they can choose a Medicare Advantage plan that has a prescription drug benefit (MA-PD)...
web page:
BenefitsCheckUp
source:BenefitsCheckUp - National Council on Aging
languages: English
from the brochure: "...BenefitsCheckUp helps you make the best decisions about the public and private programs that are available to help you save money on prescription drugs and other healthcare costs. ...
brochure :
Medicare and Other Health Benefits: Your Guide to Who Pays First
source:Federal Citizen Information Center of the U.S. General Services Administration
file size:18 pg. languages: English
"This booklet explains: How Medicare works with other types of insurance; Who should pay your bills first; Where to get more help..."
also from Federal Citizen Information Center:
web page:
Medicare Worksheet for Comparing Medicare Health Plans
languages: English
from the web pag: "...Medicare health plans may have differences among them, such as cost, choice of providers, extra benefits, quality, paperwork,complaints, and convenience. Use this worksheet to ask the questions that are important to you and compare the answers. The information you gather will help you compare plans and make the health plan choice that is right for you..."
brochure:Why should I consider switching my Medicare plan for 2008?
source:My Medicare Matters
languages: English
from the web page:"Here are some questions to ask yourself in deciding whether you should switch your plan:..."
also from My Medicare Matters:
web page:
7 Simple Steps
languages: English
"7 Simple Steps is an introduction to the Medicare prescription drug coverage, also known as Part D..."
The Medicare Drug Benefit: Straight Answers to the Toughest Questions
source:The Century Foundation
file size:19 pg. languages: English
from the brochure: "In November 2003, Congress narrowly passed the Medicare Modernization Act (MMA), legislation adding outpatient prescription drug coverage to Medicare, the federal health insurance program for older and disabled Americans. That new benefit, known as Medicare Part D... but many questions remain about how it will work. This brief provides answers—to the extent they are available—to the most common questions.
5 Questions to Help You Get Ready for the Drug Benefit
source:familydoctor.org- American Academy of Family Physicians
languages: English
from the web pag: "Medicare has added coverage for prescription medicines. This means that people who have Medicare Part A (hospital insurance) or Medicare Part B (medical insurance) are able to get insurance to pay for part of their prescription drugs. Medicare is working with insurance companies to offer this benefit. It is available no matter what your income, illnesses, or drug costs....
also from familydoctor.org:
web page:
Prescriptions and Insurance Plans
languages: English
from the web pag: "Getting a prescription filled is usually easy. But because of the high cost of prescription medicines, most insurance companies and employers are trying to control drug costs. Some of the things they are doing make getting a prescription more complicated for you and your doctor, and some of the terms they use can be confusing...."
Medicare Part D – The Drug Benefit - Time for 2008 Enrollment – Our Advice
source:Consumers Union
file size:4 pg. languages: English
from the brochure: "...We advise all Medicare beneficiaries now enrolled in a Medicare Advantage (HMO or PPO) or stand-alone Part D plan to carefully assess their prescription drug needs and satisfaction with their current plan and coverage, and to evaluate whether a switch in plans may be warranted..."
also from Consumers Union:
Web page:
Advice for 2008 Medicare Part D Drug Coverage
languages: English
from the web page: "...With dozens of plans to choose from, and the potential to fall into the dreaded ‘doughnut hole’ coverage gap, the decision can be confusing....."
Choose Your Plan: Make An Informed Decision
source:Making the Most of Your Pharmacy Benefit Plan (National Pharmaceutical Council)
languages: English
from the web pag: "...If you are enrolled in a Medicare Advantage plan, your only option for prescription coverage will be through your Medicare Advantage plan. However, if you are not enrolled in a Medicare Advantage plan, you may have a number of different Medicare Prescription Drug Plans (PDPs) to choose from.....
ANATOMY OF A PART D PLAN
source:Cornell University Resource Education for Medicare Part D
languages: English
fromthe web page: "...Medicare Part D legislation requires that all insurance companies which offer Part D prescription drug insurance must follow certain rules in designing the offerings of a plan... Companies must offer a plan that meets the requirements of a basic benefit before offering a plan with enhanced benefits. The basic benefit can meet one of three different plan designs...."
also from Cornell University Resource Education for Medicare Part D:
Medicare brochure or publication:
Understanding the Coverage Zones
file size: 9 pages; languages: English
description from brochure: "...A standard benefit Part D plan design has four coverage zones. The first zone of coverage is the Deductible, which in 2008 is $275...."
Health Plan Report Card
source:National Committee for Quality Assurance
languages: English
from the web pag: "...NCQA's Health Plan Report Card can help you answer questions about health plans that would be difficult or impossible to answer on your own-Does this health plan provide good customer service? Will I have access to care I need? Does the plan check doctors' qualifications? If I get sick, which plan will take better care of me?...
Use this chart to compare your Medicare options
source:Medicare Rights Center
languages: English
from the web pag: "...The chart below compares the benefits of Original Medicare to the most common types of Medicare private health plans. Click on a question, the type of Medicare plan, or each light for more details....
2008 SUMMARY OF MEDICARE PRESCRIPTION DRUG PLANS (PDPs) & MEDICARE ADVANTAGE PRESCRIPTION DRUGS PLANS (MA-PDs)
source:CENTER FOR MEDICARE ADVOCACY, INC.
languages: English
from the brochure: "Medicare Part D drug coverage is provided by a variety of private plans, not by the Medicare program itself. This is different from the way Parts A and B work. Also unlike Medicare Parts A and B, people have to take action to enroll in Part D. They can choose a separate Prescription Drug Plan (PDP) and stay in the traditional Part A and B Medicare program, or they can choose a Medicare Advantage plan that has a prescription drug benefit (MA-PD)...
BenefitsCheckUp
source:BenefitsCheckUp - National Council on Aging
languages: English
from the brochure: "...BenefitsCheckUp helps you make the best decisions about the public and private programs that are available to help you save money on prescription drugs and other healthcare costs. ...
Medicare and Other Health Benefits: Your Guide to Who Pays First
source:Federal Citizen Information Center of the U.S. General Services Administration
file size:18 pg. languages: English
"This booklet explains: How Medicare works with other types of insurance; Who should pay your bills first; Where to get more help..."
also from Federal Citizen Information Center:
web page:
Medicare Worksheet for Comparing Medicare Health Plans
languages: English
from the web pag: "...Medicare health plans may have differences among them, such as cost, choice of providers, extra benefits, quality, paperwork,complaints, and convenience. Use this worksheet to ask the questions that are important to you and compare the answers. The information you gather will help you compare plans and make the health plan choice that is right for you..."
What drugs do Medicare Drug Plans Cover?
source: U.S. Administration on Aging (U.S. Health & Human Services)
4 pages; languages: English
from the brochure: "Medicare drug plans must cover prescription drugs in all prescribed categories and classes but Medicare drug plans don’t have to cover every drug. Certain drugs may be excluded*. Although your drug plan may not have a specific drug on their list of covered drugs (formulary), a similar drug that is safe and effective should be available. This may be in the form of a therapeutic alternative or generic drug... "
State Medicare Help & Publications
State-by-state help to information about Medicare, Medicare health plans, contact information and publications, as well as information about Medicare Prescription Drug Insurance and Plans in each state Advertising - Links - Listings
Copyright 2007 Quickbrochures/Dibbern& Dibbern, except for content excepts and
data from federal and state agencies
Copyright 2007 Quickbrochures/Dibbern& Dibbern, except for content excepts and
data from federal and state agencies