Medicare part D coverage and its influence on transplant patients' out-of-pocket prescription expenses

Abstract

Since Medicare is available for qualifying individuals because of age (65 years or greater), disability, or end-stage renal disease, many transplant recipients have Medicare coverage. Everyone who is entitled to Medicare will qualify to enroll in a Part D plan - a voluntary prescription drug coverage option offered by private insurance companies who meet the standards established by Medicare. The addition of Medicare Part D may help reduce out-of-pocket medication expenses for transplant recipients who have Medicare; however, the reality of utilizing Part D to maximize recipients' benefits is not simple, but rather complicated. The intricacies of Part D involve not only understanding premium costs and benefit stages, but formularies, and, particularly for transplant patients, deciphering how Medicare Part B immunosuppressant coverage influences Part D coverage. This article details significant information concerning Part D that transplant health care professionals should know in order to maximize patients' benefits and minimize their out-of-pocket medication expenses. © 2006 The Authors.