Medicare Prescription Drug Coverage-Part D



Medicare Prescription Drug Coverage-Part D

Introduction

Medicare insurance is a program of the government which provided health insurance to seniors once they reach the age of 65 years. Medicare Part D is a part of Medicare insurance that is able to pay for some or large part of anyone's prescription expenses. This program came into effect on January 1, 2006. Medicare Part D doesn't entertain automatic enrolments, so one has to get enrolled in a period of time for best rates. The program also imposes a penalty per month if an individual doesn't enroll during that time. This penalty will continue even if that individual gets enrolled. Medicare covers some individuals due to their financial circumstances. If anyone is not considered eligible for this category, he or she will have to pay an insurance premium on monthly basis and a portion of the cost of drugs (Fincham, 2007).

If anyone wants to get Medicare Prescription Drug Coverage, there are two ways that has been defined. These procedures have been offered by insurance and private companies approved by Medicare (Huynh & Guterman, 2006). These include:

Medicare Prescription Drug Plans

Medicare Advantage Plans

Now Medicare Part D also has certain rules to operate.

The individual and/or the prescriber must contact the plan, to show that the drug is medically essential to be in the plan.

There are also certain limits on how much medication anyone can get at a time.

One has to try some lower cost drugs before the plan covers the prescribed drugs.

Discussion

Stakeholders and the Part D

The Medicare Prescription Drug, Improvement and Modernization Act was made a law on December 8, 2003. It is commonly known as the Medicare Modernization Act (MMA) and maintains how anyone can get additional assistance in the Medical Program. Several stakeholders played their roles when the Medicare Part D was in the process if implementation. The Bush administration realized that there were some issues with its implementation. It was on February 12, 2006, when the former president said that on average, medical beneficiaries will have to pay half the amount they paid before the implementation of the drug benefit. There went several appeals asking for changes in Medicare Part D, while the Bush administration and Republicans believed that the concerns associated with the Medicare Part D should be fixed by management tools.

Democrats

Democrats were quick to do their part of criticizing Medicare Part D and called on party members to conduct meetings and public events and vowed to continue working against the program and the Bush management leading it. Democrats wanted to see several legislative amendments in the Medicare Part D which included that additional drugs should be added to the formularies of the drug plan cover. They also recommended that the plan should provide beneficiaries with a 60-day drug supply not covered in the plan and a 60-day drug supply when a pharmacist is unable to confirm the beneficiaries' enrolment in the plan. They also asked to create appeal process, to prohibit drug plans eliminating any beneficiary from a ...