Medicare Part D

Part D Prescription Drug Coverage

Medicare Part D Prescription Drugs plans were introduced in 2006 and are a voluntary outpatient prescription drug benefit for people on Medicare. All 57 million beneficiaries of Medicare, including those ages 56 and older and those under the age of 65 with permanent disabilities, have access to the Medicare Part D Prescription Drug benefit through private plans approved by the federal government.

In 2016, nearly 41 million Medicare Beneficiaries enrolled in a Medicare Part D Prescription Drug Plan. During the Open Enrollment Period, which runs from October 15 to December 7 each year, beneficiaries can choose to enroll in either stand-alone prescription drug plans (PDPs) to supplement Original Medicare Part A and Part B or Medicare Advantage prescription drug (MA-PD) plans that cover all Medicare benefits including drugs.

Beneficiaries with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost-sharing. To qualify for the Part D Low-Income Subsidy (LIS) program, enrollees must fall under 150% of the federal poverty level ($17,820 for individuals in 2016) and have modest assets (less than $13,640 for individuals in 2016).

According to the Centers for Medicare & Medicaid Services (CMS), the 2017 Medicare Part D Prescription Drug Plan base beneficiary premium is $35.63. Actual PDP monthly premiums vary across plans and regions. In 2017, the Part D standard benefit has a $400 deductible and 25% coinsurance up to an initial coverage limit of $3,700 in total drug costs, followed by a coverage gap. During the gap, enrollees are responsible for a larger share of their total drug costs than in the initial coverage period, until their total out-of-pocket spending in 2017 reaches $4,950.

For more information on understanding Medicare Part D Prescription Drug Plans, product available in your market, compliant marketing materials, and certification information, give us a call at 800-962-4693 or locate your Regional Sales Director by clicking here.

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