What is Medicare Part D?
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 $4,550 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 October 15 to December 7, 2012. Penalties may apply to eligible Medicare beneficiaries who do not enroll in Medicare Part D when they are first eligible. |
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Medicare Part D Spending Phases For 2012 |
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| Phase 1 | Calendar Year Deductible | $320 (Providers may waive the deductible). |
| Phase 2 | Initial Coverage Limit | $2,840 Members pay co-pays until the entire amount spent on prescription drugs (co-pays, plus what the plan pays) equals $2,840. Providers may offer various co-pays and formularies. |
| Phase 3 | Coverage Gap (Doughnut Hole) | $2,840 to $4,550 Members pay 100% of prescription coverage until the true out of pocket costs (TrOOP) exceed $4,550. Note only co-pays count toward TrOOP. |
| Phase 4 | Catastrophic Coverage | $4,550 or greater TrOOP Co-pays of $2.50 for generic or brand drugs that is a multi-source drug and $6.30 for all other drugs, or 5% coinsurance and the Plan pays 100% of the balance. |
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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. |
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Starting
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.