To cover the Part A and Part B benefits, Medicare offers a choice between an open-network single payer health care plan ( traditional Medicare ) and a network plan ( Medicare Advantage, or Medicare Part C ), where the federal government pays for private health coverage.

Medicare Part D covers outpatient prescription drugs exclusively through private plans, either standalone prescription drug plans or through Medicare Advantage plans that offer prescription drugs

Initially Medicare consisted exclusively of Part A, which covers hospital and other inpatient services, and Part B, which covers outpatient care, physician visits, and other “ medically necessary services .” Congress then added Medicare Part C ( originally called Medicare + Choice, then later changed to Medicare Advantage ), which allows enrollees to receive their Medicare benefits through a private plan, under the Balanced Budget Act of 1997, while Medicare Part D was created under the Medicare Modernization Act of 2003.

Fares are $ 1. 50 for adults, and $. 75 for children 5-11, for students with valid I. D, for handicapped / Medicare recipients, and for senior citizens age 65 and up.

* Voted NO on requiring negotiated Rx prices for Medicare part D. ( Jan 2007 )

* Berkowitz, Edward D .; Kingson, Eric R. Social Security and Medicare: A Policy Primer Auburn House.

Parts B and D are funded by premiums paid by Medicare enrollees and general fund revenue.

Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits.

Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD.

A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan.

Medicare Part D went into effect on January 1, 2006.

Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Modernization Act.

Unlike Original Medicare ( Part A and B ), Part D coverage is not standardized.

It should be noted again for beneficiaries who are dual-eligible ( Medicare and Medicaid eligible ) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.

Medigap policies sold after the introduction of Medicare Part D on January 1, 2006 are prohibited from covering drugs.

On average, Medicare covers about half ( 48 percent ) of health care costs for enrollees.

* Medicare covers 75 % of the cost of covered services on average and 48 % of average costs for all medical services, and the typical enrollee faces over $ 3, 000, while 10 % of enrollees have over $ 8, 300 in out of pockets costs.

Part B coverage begins once a patient meets his or her deductible ($ 140 in 2012 ), then typically Medicare covers 80 % of approved services, while the remaining 20 % is paid by the patient.

Traditional or " fee-for-service " Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country.

In the United Kingdom, the NHS covers cochlear implants in full, as does Medicare in Australia, Seguridad Social in Spain and Israel.

Medicare covers nursing home services for up to 100 days for beneficiaries who require skilled nursing care or rehabilitation services following a hospitalization of at least three consecutive days.

A freestanding facility is generally part of a nursing home that covers Medicare SNF services as well as long-term care services for people who pay out-of-pocket, through Medicaid, or through a long-term care insurance policy.

Although many Canadian citizens have supplemental private insurance from their employers, this covers non-medically necessary expenses not covered by Canadian Medicare, and accounts for 12 % of national health care spending.

* Voted YES on limited prescription drug benefit for Medicare recipients.

Pursuant to the Medicare Modernization Act of 2003, " Medicare + Choice " plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as " Medicare Advantage " ( MA ) plans.

Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare ( Parts A & B ), such as prescription drugs, dental care, vision care and gym or health club memberships.

In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan ( PDP ) or Medicare Advantage plan with prescription drug coverage ( MA-PD ).

He accomplished this largely by reducing spending on social services, most notably Medicaid ; the 2005 budget drastically reduced coverage for 65, 000 individuals classified as Poverty-Level Aged and Disabled ( PLAD ), most of whom qualified for the federal Medicare program, and also significantly limited prescription drug coverage.

Benjamin Zycher, former Senior Fellow at Manhattan Institute's Center for Medical Progress, opposes allowing the federal government to negotiate prices in the Medicare Part D prescription drug program, and argues that patients and their doctors should make their own decisions to choose drugs like Vioxx, rather than having the U. S. Food and Drug Administration decide on the basis of " bureaucratized ... scientific study ".

In 2003, Chafee voted against the Medicare Part D prescription drug benefit.

* Voted against Bush ’ s Medicare prescription drug bill

Professor Leonard E. Berman of Syracuse University testified to a U. S. Senate committee in July 2010 that: " My guess is that if President Bush had announced a new war surtax to pay for Iraq or an increase in the Medicare payroll tax rate to pay for the prescription drug benefit, both initiatives would have been less popular.

Grassley voted in favor of end-of-life counseling as part of the 2003 Medicare prescription drug bill.

Beginning in 2006, a prescription drug benefit, called Medicare Part D, was made available.

The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates.

Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases.

All costs related to the terminal illness are paid from a per diem rate (~ US $ 126 / day ) that the hospice agency receives from Medicare-this includes all drugs and equipment, nursing, social service, chaplain visits, and other services deemed appropriate by the hospice agency ; Medicare does not pay for custodial care.

As new and expensive drugs have come into use, patients, particularly senior citizens for whom Medicare was designed, have found prescriptions harder to afford.

These include universal health insurance, Medicare and Medicaid coverage, tobacco, AIDS, air and water quality standards, pesticides, nursing home quality standards, women's health research and reproductive rights, the availability and cost of prescription drugs, and the right of communities to know about pollution levels.

Specifically, the Act expanded the Medicare program to provide protection against catastrophic medical expenses and for the first time, provided coverage under the Medicare program for prescription drugs.

Pharmacies purchase PBS-listed drugs from the wholesaler or supplier, and claim the difference between the dispensed price and the patient co-payment contribution from Medicare Australia.

In Canada all drugs given in hospitals fall under Medicare, but other prescriptions do not.

This mostly goes towards services not covered or only partially covered by Medicare, such as prescription drugs, dentistry and optometry.

Known as Medicare Part D, this program engages private insurers to negotiate with pharmaceutical companies for the placement of drugs on tiered formularies.

He also supports the importation of prescription drugs to the U. S., and wants to expand prescription drug coverage under Medicare so that more people can be covered.

Medicaid will still cover drugs for dual-eligible patients that are not covered by Medicare Part D, including certain controlled substances.