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What is Medicare Part D?

Senior woman sitting outsideStarting January 1, 2006, Medicare began  providing insurance coverage for prescription drugs through a program called Medicare Part D. Insurance companies and other private companies  work with Medicare to provide a choice of plans that cover both brand name and generic brands. If you are currently enrolled in Medicare Parts A and/or B you qualify for the new Medicare Prescription Drug Coverage.

Medicare, on average, will pay approximately 75% of the total monthly premium for this insurance coverage. You will be responsible for monthly premium which may range from $30-$90. Medicare Part D will also provide peace of mind because it protects you if your drug spending is more than $4,050 in a year. Even if you don't use a lot of prescription drugs now, you should consider joining.

The initial sign-up period began November 15, 2005 and ended May 15, 2006. Coverage began January 1, 2006. Plan changes and enrollments may only happen during open enrollments. Open enrollments are scheduled to be the last 45 days of each year. The next open enrollment is November 15 to December 31, 2008.  Penalties may apply to eligible Medicare beneficiaries who do not enroll in Medicare Part D when they are first eligible. 

Medicare Part D Spending Phases For 2008

Phase 1 Calendar Year Deductible $275
(Providers may waive the deductible).
Phase 2 Initial Coverage Limit $2,510
Members pay co-pays until the entire amount spent on prescription drugs (co-pays, plus what the plan pays) equals $2,510.

Providers may offer various co-pays and formularies.
Phase 3 Coverage Gap (Doughnut Hole) $2,510 to $4,050
Members pay 100%  of  prescription coverage until the true out of pocket costs (TrOOP) exceed $4,050. Note  only  co-pays count toward TrOOP.
Phase 4 Catastrophic Coverage $4,050 or greater TrOOP
Co-pays of $2.25 for generic or brand drugs that is a multi-source drug and $5.60 for all other drugs, or 5% coinsurance and the Plan pays 100% of the balance.

Click here for the Pharmacy Locator and Formulary Information for the United American Insurance Company Part D Program.

This chart is designed to provide basic information about the Medicare Part D Prescription Drug Coverage Plan. For more information about Medicare Part D  visit Medicare.gov or contact Retirement Council, Inc.