What Is Medicare Part D?

Medicare Part D Insurance

Medicare Part D—also known as the Medicare prescription drug benefit—is an optional federal government program designed to help Medicare beneficiaries cover the cost of self-administered prescription drugs. While Medicare Part D was created as part of the Medicare Modernization Act of 2003, it did not officially go into effect until January 1, 2006. Prior to 2006, many Medicare beneficiaries struggled to cover the high cost of retail prescription drugs that their Original Medicare plans didn’t cover. Although Medicare Part D was established by the federal government, unlike Original Medicare (Parts A and B) which is publicly administered, Medicare Part D is provided exclusively by private companies.

What Does Medicare Part D Cover?

Medicare Part D covers the cost of self-administered prescription drugs. While drugs that are administered by a medical professional during an operation or hospital stay are typically covered by Original Medicare, medications for which patients receive prescriptions, get filled at a pharmacy, and administer themselves are usually covered by Medicare Part D. However, Medicare Part D only covers drugs that are deemed “medically necessary” which means that not all drugs are covered. Some examples of common prescription drugs that are not covered by Medicare Part D include medications used for cosmetic purposes, weight loss or weight gain, erectile dysfunction, fertility, or any drug that has not been approved by the Food and Drug Administration (FDA). In order to receive Medicare Part D, a beneficiary must already be enrolled in Medicare Part A and/or Part B.

Get Started Today

To learn more about how Medicare Part D can help your clients cover the cost of prescription drugs, enroll in our Medicare Products training course. Or, to begin contracting with MCC Brokerage, contact us today.

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