Medicare Part D is a voluntary outpatient prescription drug benefit for Medicare beneficiaries, provided through private plans approved by the federal government. Beneficiaries can choose to enroll in a stand-alone prescription drug plan (PDP) each year to supplement traditional Medicare (Parts A and B) and their Supplemental (“Medigap”) medical plan (if one is in force) or select an “Advantage” plan which includes Part D coverage and replaces original Medicare.
The Congressional Budget Office (CBO) estimates spending on Part D benefits will total $99 billion in 2019—highlighting the importance in understanding the minimum standard set for all Part D plans each year by the Centers for Medicare & Medicaid (CMS) and for beneficiaries to carefully consider their Part D coverage options (based on their Rxs, plan benefits available, plan formularies and premiums).
Our chart: Medicare Part D Standard Benefit 2020 demonstrates the standard prescription drug benefit that plans must provide at minimum for their members. Many plans will provide richer benefits than the standard, but lesser benefits are not permissible.