- About the Project
- Educational Programming
- Reports on Part D Policy Details
- Comparing New York State Prescription Drug Plans
- Anatomy of a Part D Plan
- Glossary of Terms
- Common Acronyms
- Preparing and Promoting an Enrollment Clinic
- Tip Sheets from CMS
- Medicare and You
- Affirmations
- Mission Vision and Objectives
ANATOMY OF A PART D PLAN
Medicare Part D legislation requires that all insurance companies which offer Part D prescription drug insurance must follow certain rules in designing the offerings of a plan.
Companies must offer a plan that meets the requirements of a basic benefit before offering a plan with enhanced benefits. The basic benefit can meet one of three different plan designs:
Standard Benefit
Actuarially Equivalent
Basic Alternative
Enhanced Benefits is a fourth type of plan design that provides coverage beyond the limitations set forth my Part D legislation. This additional, more generous coverage, is not subsidized by Medicare.
There are 34 Part D regions into which the country is divided. No state can be divided into more than one region. Multiple states make up some of the regions.
An insurance company may offer up to three plans in a region. The company may have more than two plans in a region if one of the plans includes benefits in the coverage gap
.
AUDIO RECORDINGS OF RADIO INTERVIEWS
This material is based upon work supported by a grant from the Dean of the College of Human Ecology and Smith Lever funds from the Cooperative State Research, Education, and Extension Service, U.S. Department of Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture.