published in NAELA Journal, Vol. 1, No. 2, pp. 167-186, Fall 2005


This article examines the Medicare Part D prescription drug benefit that became effective on January 1, 2006. The article begins by setting forth the political development of this benefit and explaining the constraints that were imposed by the ill-fated attempt in 1988 to add prescription medications to Medicare’s coverage. The article then examines the key components of the Medicare drug benefit, including its unique coverage gap known popularly as the “doughnut hole,” and illustrates how beneficiaries will fare depending upon their level of annual drug expenditures. After considering the program’s penalty for delayed enrollment, the article analyzes the perplexing decisions that Medicare Part D presents for Medicare beneficiaries who have drug coverage from former employers, medigap insurance policies, or managed care plans. The article concludes with some perspective about the uncertainties faced by older Americans as they contemplate what their drug regimens might entail in the future.


Law and Economics

Date of this Version

December 2005