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How Does Medicare Part D Fit Together with Medicare Part A and Medicare Part B?
WHAT IS MEDICARE PART D?
Medicare Part D Prescription Drug Coverage is a voluntary program developed to help Medicare recipients deal with the rising cost of prescription medications. By paying a monthly premium (anywhere from a few dollars to around $60), you will be able to purchase most prescription medication at a lower price (sometimes even at no cost - $0 for generics).
- Part A - pays for inpatient hospital, skilled nursing facility, and some home health care.
- Part B - covers Medicare eligible physician services, outpatient hospital services, certain home health services, and durable medical equipment.
- Part C - or Medicare Advantage plans (previously Medicare+Choice), make available Medicare-covered health care services through a Medicare private health plan, such as an HMO, PPO or Private Fee for Services plan.
:: Who ie eligible for Medicare Part D?
:: Can I be enrolled in more than one Medicare Part D plan?
:: How does Medicare Part A work?
:: How does Medicare Part B work?
:: I am enrolled in a Medicare Advantage Plan (Medicare Part C), can I also enroll in a Medicare Part D plan?
Who ie eligible for Medicare Part D?
If you are entitled to Medicare benefits under Medicare Part A or enrolled in Medicare Part B; and you reside in the service area of the Medicare prescription drug plan - you are eligible for the Medicare Part D program. (Usually Medicare is available for people 65 and older, people who are under 65, but qualify for Medicare coverage, and people with End Stage Renal Disease).
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:: Click here to read how the Medicare Part D plans actually work!
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Can I be enrolled in more than one Medicare Part D plan?
NO -
You may be enrolled in only one Medicare Part D plan at a time.
Many people are confused with the enrollment process and enroll in more than one plan. If you have enrolled in two plans, the most recent enrollment is probably effective and the first enrollment will be cancelled by your re-enrollment. If you are not sure if you are enrolled in a plan, contact the plan first before re-enrolling.
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How does Medicare Part A work?
Medicare Part A:
pays for inpatient hospital, skilled nursing facility, and some home health care. For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (in 2006 the deductible = $952) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.
Medicare Part A premiums are charged on the basis of how many quarters of Medicare-covered employment. In fact, most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment. If a person has between 30-39 Quarters, the Part A premium is $216.00. For people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment., the Medicare Part A premium is $393.00 per month.
- Medicare Part A will cover your prescription medications that you need during your Medicare-covered hospital or skilled nursing facility stay.
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How does Medicare Part B work?
Medicare Part B:
covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment for $124.00 per year. The Beneficiary pays 20% of the Medicare-approved amount for services after meeting the $124.00 deductible.
The 2006 monthly premium for Medicare Part B =$88.50 per month.
- Medicare Part B will cover your prescription medications administered by your physician or dialysis facility, as well as some of your outpatient prescription drugs.
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I am enrolled in a Medicare Advantage Plan (Medicare Part C), can I also enroll in a Medicare Part D plan?
Probably not - Always check with your plan administrator
Medicare Part C, or Medicare Advantage plans (previously Medicare+Choice), make available Medicare-covered
health care services through a Medicare private health plan, such as an HMO, PPO or Private Fee for Services plan. There are two variations of Medicare Advantage Plans, those with (MA-PD) and those without prescription drug coverage (MA). If you are enrolled in a Medicare Advantage plan that includes prescription drug coverage (MA-PD), you usually can not enroll in a Medicare Part D Prescription Drug Plan, unless you are a member of a Private Fee-for-Service MA Plan (PFFS) a Medical Savings Account MA Plan (MSA), or a 1876 Cost Plan.
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Last updated on: 11/14/2008
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