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Medicare Part D Policy Analysis Name: Institutional Affiliation: Medicare Part D Policy Medicare part D policy also referred to Medicare prescription drug coverage is a prescription drug benefit program that was created by the United States government to help beneficiaries pay for prescription drug costs…
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The program has received praises because it more affordable than the other Medicare programs; the program cuts into half the drug expenditures of beneficiaries. Like Medicare part B, Medicare part D is not mandatory. It is optional and has a cost that is to be paid by the beneficiaries on a monthly basis. Each beneficiary pays 25 percent of the coverage cost and federal government pays the remaining 75 per cent of the premium (Dallas, 2006). However, if a person initially rejects the program, he or she pays a late enrollment penalty to begin the program later. Medicare part D program provide a large list of approved drug plans for the beneficiaries to choose from. However, the plans do not cover all prescription drugs, thus it is important that the users choose a program that meets their needs. Goal One of the major goals of Medicare part D policy was to rely on the competition among private plans to control drug prices and drug spending. This was aimed at lowering the cost of prescription drugs in favor of the beneficiaries. However, although the program was developed with an aim of making medication more affordable, it is yet to achieve this goal because about half the total number of beneficiaries still complains of high costs of medications. Moreover, with the program having no authority to negotiate the prices with the drug agencies, this does not seem to be achievable (Neuman, Cubanski and Kimberly, 2008). Target Population of the Policy The Medicare part D policy or program targets all citizens of the United States of America who are above 65 years of age. However, those below 65 years can also be considered for the program but under certain critical medical conditions. For example, persons who need kidney transplant due to kidney failure (Medicare.org 2011). Enrollment To be eligible in part D plan, beneficiaries must affirmatively enroll for the program. Enrollment is done annually and it last from 15th October to 7th December. Eligible Medicare beneficiaries who fail to enroll during this enrollment period pay a late enrollment penalty in order to receive the part D coverage. The penalty is often calculated from the national average premium and number of full calendar months they were not enrolled (Salzman, 2004). Eligibility People who eligible for Medicare part D are those already enrolled in both part A and B due to three different factors. One of the factors is the End Stage Renal Disease (ESRD) which requires anyone suffering from such a disease to apply for Medicare part D coverage. Second is the age factor which argues hat part D applicants should be 65 years and above (Fincham, 2007). Lastly is disability factor which allows individuals with total disability to apply for the coverage. Generally, any person who is 65 years of age or above and has been a legal resident of the United States of America for at least five years is eligible for the Medicare part D coverage. People who have disabilities and are below 65 years may also be eligible if they receive Social Security Disability Insurance Benefits. However, if they stop receiving Social Security Disability Insurance, they lose eligibility to the part D Medicare (Barry, 2008). There are also particular medical conditions that may also enable people become eligible to enroll for the part D Medicare coverage. Persons eligible to prescription drug coverage under this plan must also be entitled to benefits under Medicare part A and B. Part D
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