Senior Care Focus

Medicare D Doesn’t Have to be Confusing

As of January 1, 2006, the federal government expanded Medicare coverage with the launch of the Medicare Part D program. This program enables seniors to get prescriptions with the benefit of an insurance program that can help lessen annual drug costs. To take advantage of the program, however, Medicare recipients have to navigate a system that may seem confusing. To understand how the new Medicare program works, it is important to understand a few basic facts.

Part D is available to everyone on Medicare. There are no other eligibility requirements. A Medicare recipient cannot be denied Part D coverage for medical reasons or income level. If you are enrolled in Medicare, the prescription coverage is available. The choice to participate, however, is up to the individual. That is, the coverage is voluntary and you have to enroll. For those who already have solid prescription coverage from other sources, it is important to carefully weigh the benefits of both. A private policy might, in fact, cover more for less cost. Look to see which plan works better for your particular situation. When enrolling in Medicare prescription coverage, the first thing recipients will notice is that there are several options from which to choose. There is no single drug plan and what is even better is that Medicare does not administer them— private drug plan companies manage the plans. For those on very limited incomes, the new Medicare coverage will cover most drug costs. For those with very high drug expenses, there is even a Medicare plan that will cover about 95 percent of the costs beyond a deductible each year. To review the different plans available, it is a good idea to speak directly to a Medicare representative or look at the agency’s web site below. The plans are diverse and are meant to assist as many people and their different situations as possible. Ideally, the best way to approach studying the different plans is to look at each of the options while keeping your personal circumstances in mind. For those who decide to use the Part D coverage, it is important to note that the discount cards issued in the past are not the same thing. Those cards only provided discounts, not insurance. The new Part D coverage replaces those on a permanent basis. Since Part D is new and may be confusing for Medicare clients to understand, it is important for interested seniors to get informed advice on choosing plans, benefits and so on. Medicare has promised to provide information to its clients each year prior to the annual open enrollment period, which will include a list of plans available and their benefits. For other help, Medicare Part D recipients or those who want to enroll in coverage should visit the Medicare web site or call 1-800-MEDICARE. State agencies and the Social Security Administration may also be able to provide informed advice. Visit the Medicare web site at


Adapted from an article by Seeley.
Senior Care Focus, Issue No. 4, Spring/Summer 2011

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