6.5k views
3 votes
What is the pharmacy reimbursement for a prescription dispensed under Medicare Part D?

1 Answer

3 votes

Final answer:

Medicare Part D covers 75% of prescription drug costs up to $2,250 for beneficiaries after an annual premium and deductible, funded by beneficiary premiums and general revenues.

Step-by-step explanation:

Medicare Part D pharmacy reimbursement for a prescription dispensed is typically 75% of the drug costs up to $2,250, after the individual has paid an annual premium and deductible. It provides coverage for a wide range of prescription drugs, and the reimbursement for each prescription is determined based on the negotiated rates between the pharmacies and the Medicare prescription drug plans.

The Medicare Prescription Drug and Modernization Act of 2003 was passed to provide assistance to the elderly and disabled with their prescription drug costs. Under Medicare Part D, beneficiaries pay an annual premium and deductible, and then Medicare covers a significant portion of their prescription expenses. Funding for this benefit comes from beneficiary premiums, which cover about 25% of Medicare's Part D costs, and general revenues, which cover the remaining 75%. However, criticism has arisen over the high costs, overhead, and inflationary impact of the program on prescription drugs. The pharmacy reimbursement mechanism has become an essential factor for pharmacies providing services to Medicare beneficiaries.

User Arbaz Alam
by
8.6k points