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When Medicare was instituted in 1965, it was viewed as a necessary component for the ongoing health and welfare of many elderly people. Since that time, Medicare has been tweaked and has become the primary source of medical health care for numerous people. Since the cost of health care in the U.S. continues to rise, Medicare will most likely continue to be indispensable for retired people and those with permanent disabilities, to be able to have affordable health care--and prescription drugs are a large part of that cost. Following are a few tips on how Medicare prescription drug coverage works.

Medicare Part D and Part C

Medicare has continued to be modified over the years in order to meet the needs of those who benefit from the program. The original Medicare plan didn’t make a provision for prescription drug coverage, and prescription drugs have become increasingly more prevalent in today’s health care system. In 2003, the United States Congress rectified that problem by passing the Medicare Prescription Drug, Improvement, and Modernization Act. Also called the MMA, Medicare Part D and Part C helps defray the cost of prescription drugs for people who qualify for Medicare and are enrolled in the prescription drug coverage program.

Qualifications

In order to be eligible to enroll in Medicare Part D or Part C you must first be qualified to receive Medicare benefits and be signed up for Medicare Part A or Part B. Medicare Part A pays for hospitalization, while Part B helps with other medical costs, excluding prescription drugs. With the institution of Part D and Part C the cost of prescription drugs became part of the Medicare coverage for qualifying individuals. In order to qualify for Part D or Part C you must first be enrolled in Part A or Part B. If you’re 65 years of age and receiving Social Security payments you’re automatically eligible for Medicare, which qualifies you for Part D and Part C.

Two-Part Program

Medicare Part D and Part C consist of a two-part program designed to help Medicare recipients pay for prescription drugs that are part of their regular medical treatment. Only those drugs actually prescribed by a physician are eligible for prescription drug coverage under Medicare Part D and Part C--and there are some drugs that are not covered, such as barbiturates, fertility drugs, or benzodiazepines. Due to the fact that Medicare Part D or Part C requires you to sign up for a Prescription Drug Plan or a Medicare Advantaged Plan through an insurance company, you may be able to have these types of drugs included in your policy. However, you will have to pay more for the coverage because Medicare Part D or Part C won’t cover them.

Medicare Prescription Drug Plan

In order to receive prescription drug coverage through Medicare Part D you must already be enrolled in Medicare Part A or Medicare Part B. Medicare Part D adds prescription drug coverage through a PDP, or a Prescription Drug Plan. To institute your PDP, you must sign up with a private healthcare company. All Medicare Part D PDP’s aren’t the same; you must do a little research to determine which program suits your needs. Consult with your doctor to find out which drugs are eligible for any specific program, and whether or not the generic as well as brand named drugs you take are included. In order to begin a PDP, you must sign up with a private insurance company, such as UnitedHealthCare, which is a private insurance company that contracts with Medicare, and honors programs such as the AARP Medicare Rx Plan. These plans are available in all 50 states, and Washington D.C.

Medicare Advantage Plans

Another type of prescription drug plan available through Medicare is called a Medicare Advantage Plan, which is usually called Medicare Part C. In order to be eligible for a Medicare Advantage Plan, you must be enrolled in Medicare Part A or Part B, the same as a Medicare Prescription Drug Plan. The major difference between a PDP and an Advantage Plan is that an Advantage Plan works similarly to an HMO or a PPO. With a Medicare Advantage Plan, you are eligible to receive significant reductions in prescription drug costs, but you must be signed up with a specific program through a private insurer. The insurance company will only pay for prescriptions that come from participating doctors or hospitals--thus the comparison to an HMO or PPO. Ask your doctor for details on which Medicare program would work best for you.

About the Author:

Written by Finley Crest. Finley writes articles on Medicare and senior topics for sites like SeniorCare.net.