Question

Medicare Part D

.a) True/False: Medicare directly manages and provides Part D services for Medicare beneficiaries.

b) Select from the following: In the initial coverage period, how much of the drug costs do Part D enrollees pay? .A – 100%; B-75%; C-50%; D-25%

c)Describe in detail the federal government’s role in the financing of Medicare Part D from premium subsidy to Medicare reinsurance of Part D.

d) Briefly describe: why was Part D implemented?

Answer 1

a. TrueMedicare Part Di authorized under the MMA, provides voluntary Medicare prescription drug plans that are open to people who are eligible for Medicare.

b .d,75% cost from government, beneficiaries pay rest through premiums, coinsurance.

c Federal government prohibited from establishing formulary .Each plan establish own formulary. US pharmacopoeia set up categories snd classes-independent non political ;drug plans following USP guidelines get approved. USP create model formulary classification of 167 therapeutic categories to be used by PDPs. Two drugs in each category snd 6categories(all or substantially all) :anticonvulsant, antidepressant, antipsychotics, antiretrovirals, antineoplastics, immunosuppresants takes any plans bargaining power, so part D pays higher prices.

dPart D is available only by prescription, approved by FDA, sold in the US, used in a medically -accepted way and it includes prescription drugs, biological products ,insulins, vaccines. It also include medical supplies associated with injection of insulin and fees for vaccine administration.