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Part D Prep
Getting up to speed on Medicare’s new drug coverage

Medicare’s new drug benefit, known as Part D, may be a welcome addition in securing protection against high drug costs for seniors, but it can also be a prescription for confusion.

Since Nov. 15, millions of seniors have been faced with selecting from dozens of prescription drug plans offered by private insurance companies through Medicare. Medicare beneficiaries in Maryland have a choice of no fewer than 47 plans offered by 19 companies. Monthly premiums range from about $6 to $70 and annual deductibles from zero to $250. (The average monthly premium is expected to be between $32 and $37; the standard deductible, $250.)

Once the deductible is paid, Medicare will cover 75 percent of the cost of prescription drugs until beneficiaries pay $2,850 out of pocket. Beneficiaries then must cover the entire costs of their medications until their out-of-pocket expenses reach $3,600. After that, Medicare covers 95 percent of drug costs.

For Medicare beneficiaries, the tricky part will be determining which among the plans offers the medicines they require at the pharmacies they routinely patronize. They also must figure out whether any “Medigap” insurance they may have, or any prescription drug coverage provided as part of their retirement benefits, is better or worse than options available under Part D.

Efforts are under way to assure that physicians and staff are informed about the new program so that they can help patients wade through its complexity.

“Our goal at Hopkins Medicine,” says Megan Lower, the Clinical Practice Association’s director of contract services, “is to have materials like posters and tabletop displays available throughout our facilities that explain the new prescription drug benefit.” A Web site,, with links to comprehensive resources, includes an electronic “tool kit” to aid faculty and staff.

Staff at Pharmaquip, the Johns Hopkins Home Care Group organization that operates several Hopkins pharmacies, has reviewed the Maryland drug plan providers’ rates and agreements and prepared to answer physicians’ questions.

Enrollment continues through May 15. The drug benefit kicks in Jan.1 for those who have signed up before then.

Neil A. Grauer



Johns Hopkins Medicine

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