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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: According to the RUPRI Center for Rural Health Policy Analysis Rural Health Brief, Rural Enrollment in Medicare Part D is Growing Slowly, about 5 million rural Medicare beneficiaries had enrolled in Medicare Part D for prescription drug coverage, as of December 2008. This figure represents over half (54%) of rural Medicare beneficiaries. 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).

According to the RUPRI Center for Rural Health Policy Analysis Rural Health Brief, June 2011: Rural Medicare Advantage Enrollment Update, as of June 2011, 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.

Last reviewed 03/12/2012

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Funding for this project was supported by Grant Number U56RH05539 from the Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services. The contents of this website are solely the responsibility of the authors and do not necessarily represent the official views of the funder.