Medicare Part D

E24252

United States federal health insurance program component prescription drug benefit program

Medicare Part D is the U.S. federal program that provides outpatient prescription drug coverage to Medicare beneficiaries through private insurance plans.

Aliases (5)

Statements (55)

Predicate	Object
instanceOf	United States federal health insurance program component → prescription drug benefit program →
administeredBy	Centers for Medicare & Medicaid Services → U.S. Department of Health and Human Services →
allows	plan-specific formularies subject to CMS review →
alsoKnownAs	Medicare prescription drug benefit → Part D →
beneficiaryCostSharingIncludes	coinsurance → copayments → deductibles →
coordinatesWith	Medicaid → Veterans Health Administration drug coverage → employer-sponsored retiree drug coverage →
country	United States →
coverageType	outpatient prescription drugs →
createdBy	Medicare Prescription Drug, Improvement, and Modernization Act of 2003 →
eligibilityRequirement	entitlement to Medicare Part A or enrollment in Medicare Part B → residence in a Part D plan service area →
excludesCoverageOf	most cosmetic drugs → most over-the-counter drugs →
fundingModel	beneficiary premiums → cost sharing → federal subsidies →
hasFeature	catastrophic coverage phase → coverage gap (donut hole) phase → formulary-based drug coverage → standard benefit design defined in law → tiered cost sharing →
hasLowIncomeSubsidyProgram	Extra Help →
hasPolicyGoal	improve access to prescription medications for seniors and disabled individuals → reduce out-of-pocket drug costs for Medicare beneficiaries →
implementedThrough	Medicare Advantage prescription drug plans → private insurance plans → stand-alone prescription drug plans →
lateEnrollmentPenaltyType	lifetime premium surcharge →
lowIncomeSubsidyAdministeredBy	Centers for Medicare & Medicaid Services → Social Security Administration →
openEnrollmentPeriod	October 15 to December 7 →
partOf	Medicare →
penalizes	late enrollment without creditable coverage →
protectedDrugClassesInclude	anticonvulsants → antidepressants → antineoplastics → antipsychotics → antiretrovirals → immunosuppressants for transplant rejection →
provides	outpatient prescription drug coverage →
regulates	beneficiary protections → pharmacy network standards → plan formularies →
requires	annual open enrollment period →
requiresPlansTo	cover drugs in all or substantially all drugs in six protected classes → offer medication therapy management programs for eligible beneficiaries →
startDate	2006-01-01 →
targetPopulation	Medicare beneficiaries →

Referenced by (10)

Subject (surface form when different)	Predicate
Medicare Part D ("Medicare prescription drug benefit") →	alsoKnownAs
Medicare Part D ("Medicare Prescription Drug, Improvement, and Modernization Act of 2003") →	createdBy
108th United States Congress ("Medicare Prescription Drug, Improvement, and Modernization Act") →	enacted
Medicare →	hasPart
George W. Bush 2004 presidential campaign ("Medicare prescription drug benefit") →	issue
Title XVIII of the Social Security Act →	legalBasisFor
Medicare Part C ("Medicare Part D prescription drug coverage") →	mayInclude
Humana ("Medicare Part D prescription drug plans") →	offers
Centers for Medicare & Medicaid Services →	overseesProgram
Medicare Part C ("Medicare Prescription Drug, Improvement, and Modernization Act of 2003") →	rebrandedBy