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Medicare Modernization Act

This federal law has been in vigor in the United States of America since 2003. If you’re a user of prescriptions drugs, you should be familiar with this act, especially with part D. Provided that you have Medicare, you could reap some valuable benefits from the Medicare prescription drug improvement and modernization act.

Let’s take a closer look at it and see how it could change your life for the better (if it hasn’t done it already, of course).

What Does It Offer?

At the foundation, the Medicare prescription drug improvement and modernization act is a subsidizing act, which means that the people who are on prescription drugs and under a Medicare plan can get their drugs with a discount.

The said people can also be eligible for premium prescription drug insurances. The Medicare has 4 parts: A, B, C, and D.

  • Medicare A: This is offered to all the citizens of America that have been employed for at least 10 years and it covers the drugs that are administered in the hospital and the nursing services.
  • Medicare B: This part covers a lot more things than the Medicare Part A: certain pharmaceuticals, physician services (and some of the non-physician ones), agents for immunosuppression, ambulance services, surgical center services, etc. The beneficiary has to pay about 20% of the total cost of the services provided to him/her.
  • Medicare C: Medicare C is a combination of Medicare A and B and it’s fundamentally a care plan managed by an organization from the private sector. It is the least used type of Medicare.
  • Medicare D: Medicare D is the subsidizing part of Medicare. The price of this plan is $37 per month and puts forth a $250 deductible. 75% of the cost of drugs is covered by Medicare as long as the costs of the drug are of minimum $251 and don’t go over $2,250. Therefore, a beneficiary of Medicare D will have to pay only 25% of the costs of the prescribed drugs he/she needs. If the costs exceed $2,250, the beneficiary has to pay the full price. If the costs exceed $5,100, Medicare will pay 80%, the beneficiary will pay 5% and the remaining 15% is covered by the plan.

Drugs That Are Not Covered

Medicare covers a lot of drugs, but some are not and will never be covered. The drugs for weight control (either gaining or losing), for example, are not covered. The same thing goes for: drugs used for the treatment of sexual dysfunction, vitamins, fertility drugs, cough medication, cosmetics, non-prescription drugs (obviously) and any drugs that haven’t been approved by the FDA.


The Medicare Prescription Drug Improvement and Modernization Act comes with a clear-cut set of both advantages and disadvantages. While it cuts down the prices on certain prescription drugs, the out-of-pocket costs are actually high.

You can get more perspective on what the Medicare Prescription Drug Improvement and Modernization Act implies here. Don’t jump headfirst into a Medicare plan unless you get some real benefits from it.

Contact BGA Insurance if you need help selecting your plan during annual enrollment, as we could save you a lot of money. The service is free!