Medicare Part D Prescription Drug Benefit Frequently Asked Questions
Frequently Asked Questions
Question: What is the Medicare Prescription Drug Benefit, and when can Medicare beneficiaries enroll?
Answer: The Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (MMA) provides elderly
and disabled people on Medicare access to prescription drug coverage
from private prescription drug plans. Medicare beneficiaries can choose
from two or more drug plans in their area. People who choose to enroll
in a drug plan pay a monthly premium to receive prescription drug benefits,
and deductible and copayment costs may also apply. Assistance with paying
premiums, deductibles and copayments is available to low-income beneficiaries.
For an overview of the Medicare Prescription Drug
Benefit, please see the Kaiser Family Foundation's fact sheet The
Medicare Prescription Drug Benefit.
Open enrollment for Medicare beneficiaries occurs from October 15 - December 7. If changes are made during open enrollment, your coverage will begin on January 1 of the following year. In certain situations, you may be able to join, switch, or drop Medicare drug plans at other times. These include: if you permanently move out of your drug plan's service area; your plan stops offering prescription drug coverage; or you enter, live in, or leave a nursing home. For further information on enrollment, see Understanding Medicare Enrollment Periods.
Question: What is the difference between a prescription drug plan (PDP) and Medicare Advantage Prescription Plan (MA-PD)?
Answer: Medicare prescription drug plans
(PDPs) provide only prescription drug coverage, as a supplement to traditional
fee-for-service Medicare. Medicare Advantage prescription drug (MA-PD)
plans cover both drugs and other Medicare benefits. For more information,
see the Kaiser Family Foundation publications:
Question: How many rural Medicare beneficiaries have enrolled in Medicare Part D and how many have enrolled in Medicare Advantage?
Answer: As of December 2008, over half (54%) of rural Medicare beneficiaries had Medicare Part D coverage. 46.7% of rural Medicare beneficiaries were enrolled in a stand-alone prescription drug plan (PDP), and 7.3% in an advantage prescription drug plan (MAPD). About 5 million rural Medicare beneficiaries had prescription drug coverage through Medicare Part D. For
more details about rural versus urban enrollment in Medicare Part D,
please see the RUPRI Center for Rural Health Policy Analysis brief, Rural Enrollment in Medicare Part D is Growing Slowly.
According to the RUPRI Center for Rural Health Policy Analysis brief, September 2010: Rural Medicare Advantage Enrollment Update, as of September 2010, approximately 1.5 million rural Medicare beneficiaries were enrolled in Medicare Advantage.
Question: Do rural Medicare beneficiaries have access to the same range of Medicare prescription drug plans as urban beneficiaries?
Answer: Rural Medicare beneficiaries have
access to stand-alone prescription drug plans that are generally the
same as the plans available to urban beneficiaries. However, the Medicare
Advantage prescription drug plans available in rural areas tend to be
less generous than those offered in urban areas. For more information
about the characteristics of Medicare prescription drug plans available
in rural versus urban areas, please see the RUPRI Center for Rural Health
Policy Analysis brief, Medicare
Part D: Early Findings on Enrollment and Choices for Rural Beneficiaries.
Credits
Maintained by: Mary Reinertson-Sand, mary@raconline.org
Last revised 04/01/2011
