Medicare Part D Basics and Policy Options for Redesign

The Centers for Medicare & Medicaid Services is the largest payer for health care in the United States. Nearly 38 million Americans rely on health care benefits through this program, 61 million when Medicare Advantage beneficiaries are included. Since taking effect in 2006, Medicare beneficiaries have had access to an outpatient prescription drug benefit through Medicare Part D. Premiums and cost-sharing amounts vary across health private plans and geographic regions. As a result, the inner workings of the Part D program can be unclear.

This briefing clarified the defining characteristics of Medicare Part D including eligibility, coverage, and benefits. Attendees learned the case for Medicare Part D redesign and the implications and tradeoffs of current policy options outlined in HR.3, HR.19, S.2543, and S.909 (such as inflation penalties) on beneficiaries and other stakeholders.