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Medicare Part D Update

August, 2005:

:: A brief summary of the Medicare Part D Prescription Drug Benefit Program
:: What are the Medicare Part D Guidelines for the new program?
:: The Most Important Dates to Remember

A brief summary of the Medicare Part D Prescription Drug Benefit Program

The Medical Reform Act (formally the Medicare Prescription Drug Improvement and Modernization Act of 2003) expands health care benefits for Medicare beneficiaries. Accordingly, in January, 2006, Medicare will launch Medicare Part D prescription drug plans (PDPs) to help beneficiaries save on prescription drug costs.

In essence, the Medicare Part D Prescription Drug plans are government-sponsored insurance policies (issued by commercial insurance companies), designed to help protect you against the ever rising costs of prescription drugs. Anyone with Medicare Part A or Part A/B can purchase a prescription drug benefit plan through private insurance companies beginning on November 15, 2005. The plans take effect on January 1, 2006.

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What are the Medicare Part D Guidelines for the new program?

Medicare set the following guidelines for Medicare Part D prescription drug plans, however, available plans may vary from these guidelines.
  • Monthly Premium - $35.00 to $37.00 Paid by the Medicare Beneficiary (actual monthly premiums not yet announced)
  • Annual Deductible - $250.00 - 100% paid by the Medicare Beneficiary
  • Cost of Prescriptions ($251 - $2,250) - 25% Paid by the Medicare Beneficiary - 75% Paid by Medicare
  • Cost of Prescriptions ($2,251 - $5,100) - 100 % Paid by the Medicare Beneficiary - 0% Paid by Medicare
  • More than $3,600 annual out-of-pocket threshold - The Medicare Beneficiary pays the greater of either 5% of the prescription drug costs or $2 for generic prescription drugs and $5 for brand-name prescription drugs. Medicare Part D pays the lesser of either: 95% of the prescription drug costs or the balance of the prescription drug costs.


:: Medicare Part D - Online Out-of-Pocket Cost Estimator
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The Most Important Dates to Remember

  • November 15, 2005
    Enrollment for the Medicare Part D Prescription Drug Benefit Plans begins.
  • November 15, 2005 - May 15, 2006
    Medicare Part D - Open Enrollment Period (No medical questions)
  • January 1, 2006
    The Medicare Part D Prescription Drug Benefit Plans become effective. At this time you can begin to use the plan that you have selected
  • May 15, 2006
    Enrollment (without penalty) for the Medicare Part D Prescription Drug Benefit Plans ends.
  • After May 15, 2006
    Medicare Part D Prescription Plan cost will increase (an estimated increase of 1% per month).


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Last updated on: 07/18/2008

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