Medicare Part D

Many proposals to reorganize Medicare could increase the financial and health risks faced by the vulnerable elderly. Turning Medicare into a premium-support system a voucher set randomly at the value of the second-least-expensive insurance plan could shift costs to elderly households. Increasing the Medicare eligibility age from 65 to 67 will leave many Americans ages 65 and 66 without insurance. The basic idea of part A Medicare payment is simple. The patient pays a deductible that approximately equal to the cost of the first day in the hospital;

Each plan is also followed by a detailed chart that breaks down which tier each medication falls under, estimated full drug cost at each pharmacy, whether any special actions are to be taken to receive the medication. There are 5 tiers that these medications can fall into, and with each plan these medications either fall into tier 3, 4, or 5. Tier 3, also known as preferred brand, are brand-name drugs that don’t have a generic equivalent. Tier 4, also known as non-preferred brand, are the higher-priced brand-name and generic drugs not in a preferred tier. Tier 5, also known as specialty, are the most expensive drugs on the drug list. Looking at drug coverage information and the estimated full drug cost at a retail pharmacy for each plan, it

Medicare part D is the prescription drug plan. Each plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different tiers on their formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost less than a drug in a higher tier. In some cases, if the drug is on a higher tier and the patient 's prescriber (the patient 's doctor or other health care provider who is legally allowed to write prescriptions) thinks the patient needs that drug instead of a comparable drug on a lower tier, the prescriber can ask the patients plan for an allowance to get a lower copayment. In the case of Mrs. Zwick Part D will cover the prescription drugs that she needs that are not covered by Medicare Part A and Part B unless those medications are on the unapproved list. What the patient will be responsible for paying

Psychiatric Diagnostic B. Geniatric daycare C. Marriage counseling D. Transportation E. Meals Prior to 2010, Medicare patients were required to pay a 50 % co-payment Prescription drugs are prescribed with part D benefits and are a large part of the healthcare system. CMS will reinforce to require a requirement that Medicare part D plans may not cover drugs if the doctors are not enrolled in Medicare. (CMS.gov 2015). Preventive services range from the Adults, to women, to children. For adults, there is a screening for alcohol misuse and the counseling.

Medicare Part D was created under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. (Medicare Part D, 2011). It is also known as the prescription Drug Plan. This plan was created to help cover cost of prescription drugs, and people who have the original Medicare or Medicare Advantage are eligible to enroll (Medicare Part D, 2011). Prescription drug coverage is only offered through HMOs, PPOs, and PFFSs and by some private companies who contract with Medicare through individual plans (Medicare Part D, 2011). Private companies are allowed to create their own customized benefit plan as long as the plan is as good as the plan outlined in the 2003 Medicare Act (Medicare Part D, 2011).

On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173).  This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare. It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration

The passage of the Medicare Drug Price Negotiation Act will also inadvertently increase access to many types of medications for individuals who qualify for Medicare Part D. There is a clause within the bill that would establish rebates to be paid by pharmaceutical companies for low-income beneficiaries. These rebates, in addition to lowered costs, would considerably lessen the financial burden placed on low-income beneficiaries. This will allow more individuals greater access to expensive medications. As an example, each year, financial reasons hinder about 16% of diabetic Part D beneficiaries from filling at least one of their prescriptions (Williams, Steers, Ettner, Mangione, & Duru, 2013). This increase in access will help mitigate the occurrence of cost-related nonadherence to prescription medications, and other such consequences

Medicare has gone through many changes through the years since President Johnson signed the programs, including Medicaid into law in 1965. Almost ¾ of the senior population, over 65 were uninsured. Even before that President Truman was eager to start a national health insurance plan, in 1945. In 2003, President GW Bush added a prescription drug plan to Medicare. Even President Teddy Roosevelt proposed a national health insurance plan when he was running in 1912. In 1972, President Nixon signed a bill allowing people with long-term disabilities under the age of 65 and patients with ESRD (End Stage Renal Disease), to be covered. Over the years more services were accepted for Medicare coverage, including hospice and home health. 2010 brought good

The advocacy groups such as the National Mental Health Association, the Epilepsy Foundation, Paralyzed Veterans of America, and United Cerebral Palsy called for changes in Medicare Part D to guarantee prompt reimbursement to beneficiaries who have been overcharged for copayments and pharmacists who have covered the cost of medications for beneficiaries because of problems with the drug benefit (American Health Line, 2009). AARP, a membership and advocacy organization which represents over 35 million people over age 50, supported the MMA and prescription drug bill. AARP's support was considered a critical factor in the bill's passage. "AARP believes the Medicare Prescription Drug Program is an important step in providing access to affordable prescription drugs for older Americans and those with disabilities (AARP , 2008).

Medicare Part D is prescription drug coverage. It’s the newest part in Medicare. It adds prescription drug coverage to original Medicare, some Medicare cost plans, some Medicare PPS plans, and Medicare Medical Savings plans. Beneficiaries choose the drug plan and pay a monthly premium.

According to Barton (2010) Long-term Care “emphasized continuous care over a period of at least 90 days for a range of acute and chronic conditions. Regardless of the length of time (i.e., from weeks to years), LTC is an array of services provided in a range of settings to people who have lost some capacity for independence because of an injury, a chronic illness, or a condition” (pg. 349). This is the description of someone who may have been in a debilitating car accident, an elderly person with Alzheimer’s and dementia, a person diagnosed with chronic mental illness, and individuals who are developmentally delayed or “disabled.” People who are placed in these type of long-term care facilities are usually screened using two different

Medicare is the federal health insurance program for people with certain disabilities, end stage renal disease, and for those who are over the age of 65. There are four different parts to Medicare, part A, part B, part C, and part D. Medicare Part A, also known as hospital insurance, covers inpatient hospital stays, care in nursing facilities, hospice care, and some in home health care. Part B is often referred to as medical insurance; it covers certain doctors’ services, outpatient care, medical supplies, and preventative care services. Medicare Part C, otherwise known as Medicare advantage plan is offered by a private

The major purpose of this work is to completely discuss about the Medicare Part D which will set an influence on the different interest groups and all the entities of government which have been set under the policy changing process. There has been a complete set environment which involved and shape the policy to make efforts as to how all the groups of the stakeholders are influences with the Medical Part D. All the legislation and the specific strategies are made in correspondence to the politics. (Powell et al., 2015). The Medicare Part D is also said to be Medicare prescription drug benefit which directs to setting the United States Federal government programs to work on the subsidizing costs of all the drugs of prescription which insure premiums for the Medicare in US. There is a great enactment which has been based on Medicare Modernization Act of 2003. In December 2003, there are major Medicare Prescriptions which have become into the Improvement and Modernisation Act to become a proper law. There has been a great benefit from the drugs which provides an entire coverage to all the disables and the elderly people who could not have the ability to manage it.

One of the problems of Medicare itself is that it doesn't cover the costs of prescription drugs for its members; this has led to one of the major reasons that the program is in danger. A great deal of personal healthcare relies on the use of drugs, and since the program doesn't cover these costs, the individual must bear them. According to the AARP, in 1999 out-of-pocket costs for prescription drugs were estimated to be $450 per person each year (AARP). Obviously, members have joined the program to defray their medical costs, but these figures indicate that they still have large costs to pay. The other problem faced by the Medicare program is that it is also suffering from a lack of funds. According to Governor George W. Bush, the financial health of Medicare is in serious jeopardy and might face deficit as soon as 2010 (Bush). As a result of these major problems, one might wonder why the plan isn't scrapped for another program; well according to polls done by the Public Agenda, an Internet public policy site, American citizens are strongly in favor of Medicare, and would rather see the problems ironed out (Public Agenda). Therefore it is necessary to come up with a solution, so that the Medicare program remains intact.

Ron is very happy as an enrolled participant of Medicare and specifically Medicare Part D. His eligibility for Medicare and the affordability of health insurance at the spry age of 74 was a blessing for Ron and his wife. Like Ron and his wife, many of the elderly depend on payments from government sources for their health care, and there is concern that this part of the system is also in decay. Medicare is a federal health insurance