Part D Medicare is also commonly called the Prescription Drug Plan or simply PDP. Created under the 2003 Medicare Act, it is primarily enacted to help defray the cost of prescription drugs to help Medicare beneficiaries in the United States. Such plans are available only from private insurance companies accredited by Medicare.

PDP’s come in the form of standalone plans (for traditional Medicare beneficiaries), PFFS’s (for holders of Medical Advantage plans), PPO’s and HMO’s. Membership to Medicare Part D is voluntary and anyone with an MA plan or original Medicare coverage may opt to enroll for prescription drug coverage.

A word of caution, though: If you are eligible for union coverage or are part of your employer’s group health insurance policy, be sure to confer with the administrator of such employee benefits first prior to enrolling in other plans or amending existing policies. This is because there is a big possibility of not regaining your union or group insurance coverage once you relinquish it; as well as losing your hospitalization and medical benefits even if your intention is to drop only the provisions for drug or medicine coverage. In most cases, this will also mean the cancellation of the respective plans for your dependents and spouse.

To be eligible for Part D Medicare, membership in either Medicare Part A or Part B (or both) is necessary. On the other hand, participation in Medicare Advantage plans requires enrollment to both Parts A and B of Medicare. You must likewise be a resident in an area serviced by the prescription drug plan that you intend to join.

If you presently do not have PDP coverage, you must consider joining one as soon as you become eligible because there is only a limited period allotted for enrollment. If you miss your opportunity to enroll in time, and decide to participate later, you will not be allowed to join without paying first the late enrollment penalty (LEP).

Generally, accredited private insurance firms that offer Medicare Part D have the liberty to assemble their own benefits package provided its overall value conforms to the basic plan standards set forth in the Medicare Act of 2003. Various plans offer different covered drug listings that are called formularies, at varying cost levels. Prospective beneficiaries can then compare the different plans offered in their localities to select the right plan for them.

A Part D Medicare plan is required to meet the following basic criteria:

– The plan must offer at least 2 types of medicines for each class.

– It must have an easy to access network of pharmacies. The list of pharmacies and drugs covered must also be conveniently available to beneficiaries.

– It must cover drugs in 6 specific categories – antipsychotics, antiretrovirals, anticonvulsants, antidepressants, immunosuppresants, and anticancer.

– For 2011, the yearly deductible must not exceed $310.

– The plan must provide catastrophic coverage at least equal to what is provided for in the Act.

– The plan should help in the transition of a beneficiary’ existing drug coverage.

– In case a medicine is medically necessary but not listed in the plan, the beneficiary must be given an exception when sought.

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