
ILLINOIS MEDICARE PART D:
Your Coverage Options
Annual enrollment, donut holes, catastrophic coverage – oh my! Medicare Part D sure sounds frightening but don’t fret! With a little knowledge, you’ll find it’s not nearly as scary as you may think.
You probably have heard a thing or two about Medicare’s prescription drug plan over the last five years. But many of you are undoubtedly still scratching your heads and asking, “what is it exactly?”
Medicare Part D is a federal program put in place to help Medicare beneficiaries with the costs of their prescription drugs. It was launched in January of 2006 as part of the Medicare Prescription Drug, Improvement and Modernization Act of 2003.
Prior to the Part D program, Medicare beneficiaries paid 100% of their medication. The purpose of Part D is to make drugs affordable to those individuals and all future beneficiaries. Of course, there were assistance programs that offered relief based on individual circumstances (and some of these still exist), but none of these were nearly as comprehensive as the Part D program now in place.
Now that you understand how the program came into existence, you might be wondering, “What is the magic formula that makes Part D what it is?”
The best way to understand Part D is to compare it against the drug coverage of your individual or group health insurance. Most individual or group health insurance plans offer two types of payment options: get your medication with a co-payment or apply the out-of-pocket retail cost of your medications to your deductible. So in a nutshell, Part D is the Medicare drug plan that works with a co-payment model. Really? That’s it? Yes. The Part D program, the long-awaited prescription drug plan now offered to Medicare beneficiaries, is just a simple medication cost reduction plan for which you pay a co-payment. That’s all there is to it.
Seems simple enough, right?
Well, it is a federal program developed by government officials, so it can never be that simple. Here are some of the complexities.
In essence, the Part D program has core components that must be incorporated into every Part D Prescription Drug Plan offered by contracting insurance carriers. Keep in mind that the premiums, deductible structure (Medicare sets the maximum deductible a plan can offer each year), and drug formularies are all determined and set by the insurance carriers, not the federal government. Also, note that not every insurance carrier is contracted with Medicare Part D or offers a Part D Prescription Drug Plan.
Beyond the insurance carrier’s stipulations, let’s review the basic components of Medicare Part D.
*Please visit our resourceful article library for a more in-depth look at the following components of Medicare Part D. You will also find articles highlighting the yearly minimum and maximum cost amounts associated with the Part D Program.