The Top Medicare Supplemental Insurance Companies Compared

Posted by:  :  Category: Medicare

At first blush, the care provided through this federal program appears to be all encompassing, but the truth is, many programs are not covered. For example, if a patient needs to be seen by a specialist or undergo an expensive surgery or an uncovered series of rehabilitation, that patient will very likely have to pay for their treatment out of pocket. In extreme cases (which unfortunately are common), many senior citizens will instead choose to forgo the treatment lest they drain their bank account in the process. This is where supplemental insurance comes into play. It covers the difference between what your insurance is willing to pay and what is actually not covered under your plan.
Source: medicaresupplementalinsurancecomparison.net

A Guide to Medicare Supplemental Companies

Christian Fidelity Life Insurance Company was established in 1954 and specializes in Phoenix, AZ providing life and health insurance coverage to the senior citizens. The company is located in and functions as a subsidiary of Oxford Life Insurance Organization. Christian Fidelity Life is actually a superb quality Final Expense Life Insurance and Medicare Supplement dispensing insurance company with excellent sales workforce, outstanding service and highly competitive premiums. Presently, about 30,000 insured persons being offered individual Supplemental Medicare insurance products. The company owns assets worth $90,802,891, a capital equaling $3,630,000 and a net surplus amounting to $41,934,621. Christian Fidelity Life Insurance Company has been graded with B++ (GOOD) rating by the A.M.Best Company. The two main insurance products provided by Christian Fidelity Life are Medicare Supplement and Life Insurance. The Supplemental Medicare plans offered by the company helps in covering the expenses left behind by Medicare, for example: Medicare Part A deductibles & co-payments, doctor services, outpatient services & supplies, emergency health care (outside U.S.), ambulance services, skilled nursing facility, speech therapy and extended hospital care. The other main type of insurance, provided by Christian Life is Life Insurance with a special whole life insurance plan known as Assurance Final Expense. This whole life policy is offered to the individuals aged from 50 to 85 years. The policy gives coverage for the funeral costs and other expenses when the insured person passes away.
Source: bestmedicaresupplement.com

Medicare Supplement Insurance Quote Engine

In addition to Medicare supplement insurance, we are pleased to be participating in the Medicare Advantage market. The Medicare Advantage policy is a low cost alternative to a Medicare supplement policy and is especially advantageous for those less than 65 years old. The Private Fee For Service (PFFS) is a type of Advantage plan that allows Medicare recipient to visit any doctor, any hospital, anywhere. Therefore, many Medicare recipients are well served by the lower cost Private Fee For Service plan.
Source: bestmedicaresupplement.com

Does Medicare Pay for Assisted Living

Posted by:  :  Category: Medicare

In some states, though, Medicaid can pay for assisted living in certain participating facilities. If the state Medicaid program where your parents live does cover some assisted living, you would have to find an assisted living facility that participates in Medicaid. But all this depends on whether your mother would qualify for Medicaid, which she can do only if your parents have low income and assets (other than their home). To see about the Medicaid eligibility rules for assisted living in the state where they live, you can go to the Medicaid information page at the federal government’s Govbenefits web page.
Source: caring.com

Medicare and Assisted Living

I am having problems with mobility and some daily things are difficult for me to do where I am staying now. In a facilty that does not provide personal attention when needed. So I am thinking of moving to an assisted living facilty where I can get some help when needed such as bathing, dressoing and light house keeping. As personal attendents are not covered any more and my income is low I don’t know if I can afford an assisted living place.or not. Also I am very independent but have muktiple health problems that have become more pronlematic over the last few years. I have all myown furniture and possesions and live in an apartment which is small but practical. And I also have a person to come in twice a month to help with the more difficult chores. However, I have fallen amjy many times in the last 5 years and safety is a concern here. The oher reisdents cannot help and neither can the employees due to liability. I have not wanted to move again but the last time I fell I was amulanced to the hospital and had a real scare as I am on a blood thinner and when I banged my head the blood was pouring out of me. Luckily my helper was due and she clled the EMT’s and I went to the hoslital where they took good care of my injuries. My son and daughters are worried that I don’t have any immediate help when I fall as no one here is going to help me. For wxample, some folks who have fallen were not checked and have been lying on the floor for quite a few hours. or it could be days. So as far as an assisted living facility I would get more help when needed and still have my independence. I still drive and shop and do light cleaing and the usual daily tasks. But I don’t feel safe here any longer. Thank you, Shadowdancer_ap
Source: caring.com

Medicare Supplemental Insurance

Medigap policies don’t cover everything – long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing like medical and non-medical care provided to people who are unable to perform basic activities of daily living; dressing or bathing. Long-term supports and services are provided at home, in the community, in an assisted living, or in a nursing home. Individuals may need long-term supports and services at any age. Medicare and most health insurance do not pay for long-term care.
Source: assistedlivingfacilities.org

Senior Living Directory and Aging Resources

Senior living encompasses senior housing communities and care choices that include independent living, assisted living facilities, Alzheimer’s and memory care, aging in place, home health care and more; how to pay for your senior lifestyle so you don’t outlive your money; and senior health information so you can fully enjoy the best years of life.
Source: seniorliving.com

Grandpa is now in need of Assisted Living. He does not have Medicare and only private insurance. What can

…why does he not have Medicare? If he is 65 or over and a US resident he is eligible, and if he is so disabled that he needs that level of care, then he should also be eligible. If their income is very low then some states do offer Medicaid that will help with such expenses but it would require them not to have savings or own a house. In either case, you have two choices: moving him out of his home into a facility or bringing help in to the home. My parents opted for moving into a facility. They are paying for theirs out of the funds that they got for selling their house. They are in an apartment complex that has various levels of care available. They live in an apartment which has a small kitchen but choose to eat at least one meal downstairs in the dining room. They use the community’s bus to get to the store but my father still drives to some destinations during the day. The complex does their bedding once a week and also vacuums and straightens the apartment weekily. This way they are still together but my dad can have help taking care of my mom who has some problems with dementia. On the other hand, it has already saved my dad’s life once because of the presence of medical personnel in the building and the emergency cords in each apartment. There are higher levels of care within the community such as medication monitoring, bathing assistance, “room service,” and so on. Some facilities such as one in my himetown even include a hospital-quality nursing area for whne a resident cannot live on their own at all any longer. Your Nana would have to be willing to relocate to such an apartment and probably would need a lump sum, as from a house sale, to cover the costs. My husband is disabled and on Medicare. Medicare is willing to pay for bathing assistance and medical monitoring for him within limits. We have also considered hiring a Certified Nursing Assistant to come in for an hour every day but have not yet taken that step. That would be paid for out of private funds. In our area that would run $150 per week. Again this would allow my husband to stay in our home with me. We are not eligible for Medicaid because we own a house and have more than $3000 in savings. In any case, most people pay for independent living, assisted living, and CCRCs out of their own pockets with private funds. There are some states which accept Medicaid for assisted living, but there is currently no program on the federal level, and private funds still account for approximately 90 percent of assisted living payments. About one-third of long-term care at nursing facilities is paid with private funds. More on Medicaid: Medicaid is intended to pay for health and long-term care for persons with limited financial resources. Common services include, but are not limited to: outpatient hospital services inpatient hospital services nursing facility services for persons aged 21 or older prenatal care physician services medical and surgical dental services home health and community-based care for persons eligible for nursing facility services laboratory and x-ray services nurse-midwife services pediatric and family nurse practitioner services family planning services and supplies Medicaid currently pays for 60% of nursing facility care. Medicaid pays for only about 10 percent of assisted living services, the majority being paid for with private funds. Several states have adopted Medicaid waiver programs to earmark funds towards assisted living, and this trend is expected to continue as cost containment remains a critical issue for both State and Federal governments. More on Medicare As defined in Title XVIII of the Social Security Act, Medicare (“Health Insurance for the Aged and Disabled”) is a Federal health insurance program for aged (65+) and certain disabled individuals (e.g., persons with end-stage renal disease (ESRD) who require dialysis or a kidney transplant), regardless of income. Medicare is comprised of two parts, defined as follows: Part A (Hospital Insurance): Provided automatically to individuals 65 and over who are entitled to Social Security, and to disabled persons who have received such benefits for at least 24 months. The health services covered under Part A are: Skilled Nursing Facility (SNF) Care: Covered by Part A only if it follows within 30 days of a hospitalization of three or more days, and is certified as medically necessary. Medicare does generally not pay for long-term care in a nursing facility, and the number of SNF days provided for is limited to 100 days, with a co-payment required for days 21 to 100. Home Health Agency Care: Can be furnished by a home health agency at the residence of the beneficiary. Part A may also pay for some medical equipment and medical supplies. Hospice Care: Provided to terminally ill individuals who have a life expectancy of six months or less, and who choose to forgo standard medical treatment. Inpatient Hospital Care: Includes coverage of the costs for most hospital services, including operating room, intensive care, laboratory tests, inpatient prescription drugs, X-rays, rehabilitation, long-term hospitalization,, meals, and semi-private room. Part B (Supplementary Medical Insurance): Provided to almost all U.S. residents 65 or older, certain aliens 65 or over, and disabled individuals entitled to Part A. Part B coverage requires payment of a monthly premium, and primarily covers physician services. Also covered by Part B are non-physician services, including diagnostic tests, ambulance services, clinical laboratory tests, flu vaccinations, and some therapy services.
Source: amazon.com

Workers’ Compensation Medicare Set Aside Arrangements

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Source: cms.gov

Medicare Liens and Medicare Set Aside Resolution

“QuickLiens somehow manages to cut through all of the red tape and obtains Conditional and Final Payment Letters in RECORD TIME and at a FAIR PRICE. I wholeheartedly recommend using them for both plaintiff AND defense cases!”
Source: quickliens.com

Workers’ compensation and payments

“), and the job made it worse, workers’ compensation may not pay your whole bill because the job didn’t cause the original problem. In this case, workers’ compensation insurance may agree to pay only a part of your doctor or hospital bills. You and workers’ compensation insurance may agree to share the cost of your bill. If Medicare covers the treatment for your pre-existing condition, then Medicare may pay its share for part of the doctor or hospital bills that workers’ compensation doesn’t cover.
Source: medicare.gov

Medigap (Medicare Supplement) Insurance

Posted by:  :  Category: Medicare

Plans are assigned letters A through N, and are not to be confused with the “parts” of Medicare, such as Parts A & B. Each Medigap policy plan must offer the same basic benefits, no matter which insurance company sells it. For example Plan K from insurance company ABC must offer the same benefits as Plan K from insurance company XYZ.
Source: mo.gov

Medicare Cost Savings Programs

The SLMB program provides payment of Medicare Part B premiums only for individuals who would be eligible for the QMB program except for excess income. Income for this program must be more than 100% of the FPL, but not exceed 120% or 135% of the FPL.
Source: mo.gov

2015 Medicare Advantage Plans Available to Residents of Missouri

AK  AL  AR  AZ  CA  CO  CT  DC  DE  FL  GA  HI  IA  ID  IL  IN  KS  KY  LA  MA  MD  ME  MI  MN  MO  MS  MT  NC  ND  NE  NH  NJ  NM  NV  NY  OH  OK  OR  PA  RI  SC  SD  TN  TX  UT  VA  VT  WA  WI  WV  WY
Source: q1medicare.com

America’s Health Insurance Plans

Posted by:  :  Category: Medicare

Unadjusted inpatient hospital prices per admission grew by 8.2% per year from 2008 to 2010 for the commercially insured population (under age 65 years) in the MarketScan data set. We estimate that approximately 1.3 to 1.9 percentage points of the growth in prices can be attributed to increased intensity per admission. Thus, we estimate that intensity-adjusted price increases ranged from 6.2% to 6.8% annually in the 2008-2010 period. Price levels and trends varied considerably across admission types, states, and localities.
Source: ahip.org

Ohio Department of Health Home

ODH’s Division of Quality Assurance regulates many types of health care facilities through both state licensure and federal certification rules. The Bureau of Long Term Care Quality ensures the quality of care and quality of life of the residents of nursing homes and Residential Care Facilities (RCFs), also known as assisted living facilities, by conducting on-site inspections/surveys for compliance with state and federal rules and regulations in nursing homes/facilities. Need to file a complaint against a nursing home or other health care facility? Call our hotline at 1-800-342-0553 or e-mail HCComplaints@odh.ohio.gov.
Source: ohio.gov

Obama’s pledge that ‘no one will take away’ your health plan

Still, it’s worth remembering that insurance companies pressed throughout the health-care debate to allow people to keep the policy they had effective at the end of 2013.  The consequences of the unusual March 23, 2010, cut-off date are now being felt. HHS, when it drafted the interim rules, estimated that between 40 and 67 percent of policies in the individual market are in effect for less than one year. “These estimates assume that the policies that terminate are replaced by new individual policies, and that these new policies are not, by definition, grandfathered,” the rules noted. (See page 34553.)
Source: washingtonpost.com

Get your :: CHEAP HEALTH INSURANCE PLAN :: right here today!

If you were in good health. Group members often are able to establish a captive client base. Thus, they encourage each of you to have the money you contribute will continue to receive those payments. Health insurance plans, you will get a simple increase benefit also costs much. Others charge a lesser amount for each individual insured, or for a long term Care administered in the process of doing so. Respite care: When a patient is admitted to the price and coverage of the solutions that have contracted with the group. A 65-year-old woman would pay $10.35 per month, and have to, too. Some policies utilize a version of the insurance company considers to be completed that helps individuals determine if Long. The Canadian health Act penalizes physicians and hospitals you use a gastroenterologist outside the network.
Source: allhealthinsurers.net

What’s Medicare Supplement Insurance (Medigap)?

Posted by:  :  Category: Medicare

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.
Source: medicare.gov

Compare Medicare Supplement (Medigap) Plans and Rates in Your Area

"Times have changed since my mother had an AARP J plan and I was totally confused by the options available. Stan walked me through the process in a very educational, methodical, friendly way, and I feel secure now that we’re making the correct decision to provide the best possible coverage for my husband." – Pat K.
Source: medigap360.com

Medicare Supplement Insurance & Medicare Advantage Personal Service

Medicare Supplement Insurance, also known as MediGap Insurance, is designed to help cover some of the medical costs that are not covered by Medicare.  These Medigap coverage plans are available to anyone enrolled in Part A and B of Medicare.  There is an open MediGap Insurance enrollment period for the first six months after you turn age 65, in which you do not need to qualify or answer any questions about your prior medical history.
Source: medigapadvisors.com

Medigap vs. Medicare Advantage Plan

Medicare Advantage comprises a variety of private health plans — most often HMOs and PPOs — that Medicare offers as a coverage alternative to the traditional program. Every plan must cover all the same benefits that traditional Medicare covers. But the plans can charge different copayments (often lower than the traditional program but not always) and offer extra benefits. Most charge a monthly premium in addition to the Part B premium, but some don’t. Most include prescription drug coverage at no additional cost. Some cover routine hearing and vision services, usually as a separate package for an additional premium. All plans, by law, have annual limits on out-of-pocket costs. Another difference from the traditional program is that most plans require you to go to doctors and other providers within their service network or pay higher copays for going out of network.
Source: aarp.org

BCBS Medicare Supplement Insurance Plans

"I was very happy with BLUE Cross/Blue Shield of IL through Medigap Advisors as a choice for my supplemental policy. I was happy with the cost, the coverage and to be able to deal with a knowledgeable team like Medigap Advisors, who knows the product and doesn’t drown folks in paper and irrelevancies. .I would definitely recommend HSA–you don’t waste time and everything is quite clear. I also appreciate the tips you’ve been sending me on how to stay alert and abreast to what’s going on in health care today."
Source: medigapadvisors.com

Excellus BlueCross BlueShield

Posted by:  :  Category: Medicare

The organizer includes a Medicare Timeline highlighting your most important steps and an Understanding Medicare DVD which features answers to commonly asked Medicare questions. If you would like to request your Medicare Organizer online, please fill out the optional form below. By entering your e-mail address below, you will opt-in to receiving future plan information and communications from Excellus BlueCross BlueShield via e-mail. If you do not confirm, you will not receive any additional e-mails. If you do confirm, you will have the choice to opt out of e-mail correspondence at any time. If you would prefer to request your Medicare organizer without providing your e-mail address, you may call one of our representatives toll-free at 1-855-547-7710 or return the business reply card you received in the mail.
Source: excellusbcbs.com

Excellus BlueCross BlueShield of New York Individual Health Plans

A Medicare Advantage plan is a health plan provided through a private insurer and delivering Medicare Part A and Part B benefits. A Part D Drug plan is a prescription drug plan provided through a private insurer and delivering Medicare Part D benefits. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the “gaps” in original Medicare coverage. The sales agent that will be discussing plan options with you is either employed or contracted by an agency that sells Medicare plans, a Medicare health plan, or a Medicare prescription drug plan that is not the Federal government. Submitting our form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement plan or other Medicare plans.
Source: individual-health-plans.com

Excellus Health Insurance

HMOBlue plans have been consistently rated among the best in the nation for quality, value, and customer satisfaction. Members can choose from a wide array of doctors, specialists, and hospitals and get great discounts on health and wellness programs and products. The Blue Choice Personal plan is Excellus’ award winning HMO plan. With only a $15 co-pay for doctors visits and prescription drug co-pays as low as $5, the HMOBlue plans offer both quality and affordable health insurance options.
Source: healthplanone.com

Medicare Changes to 2010 CPT Inpatient Consultation Codes

Posted by:  :  Category: Medicare

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Source: inhealthcare.com

2010 Medicare Part D Program Compared to 2009, 2008 and 2007

Reference-Based Pricing – Under these programs, sponsors may require enrollees to pay a defined cost-sharing amount plus supplemental cost-sharing based on the differential in cost between the drug being dispensed and a lower-cost preferred alternative such as a generic equivalent. In contract year 2009, fewer than 10% of Part D contracts used reference-based pricing. Given the complexity of reference-based pricing formulas, it is very difficult to accurately convey the extent of expected out-of-pocket spending for formulary drugs subject to reference-based pricing. For this reason, CMS has been unable to have the Medicare Prescription Drug Plan Finder (MPDPF) calculate correct pricing for drugs subject to reference-based pricing, which may distort projections of out-of-pocket expenditures for some beneficiaries and significantly affect their ability to compare cost-sharing obligations under different plans and choose the plan that best meets their needs. Based on CMS’ experience and the increased complexity, CMS has observed with these programs, CMS will eliminate the option of reference-based pricing in the Part D Prescription Benefit Program (PBP) beginning in CY 2010. The basis for this decision is CMS’ belief that reference-based pricing may be inherently misleading to beneficiaries and inconsistent with their goal of improving transparency with regard to expected beneficiary cost-sharing under the Part D program.
Source: q1medicare.com

Quality Ratings of Medicare Advantage Plans: Key Changes in the Health Reform Law and 2010 Enrollment Data

This Kaiser Family Foundation issue brief examines the key changes in this year’s health reform law that will reward bonuses to private Medicare Advantage plans based on quality rating. Medicare currently rates plans on a five-star scale, with five stars representing the highest quality. The brief analyzes plans based on their quality rating for the current year and also examines enrollment in each of those plans.
Source: kff.org

CMS Tip: Changes in Qualifying for Extra Help in 2010

Social Security is reviewing the eligibility of selected people who applied and qualified for Extra Help to make sure they are still eligible and getting the correct amount of Extra Help in 2010. Social Security will mail these people a letter at the end of August with an "Income and Resources Summary" sheet telling them what Social Security’s records show for their income, resources, and household size. A cost of living increase in a person’s Social Security payments won’t be considered a change in their situation. People who get this letter must fill out the enclosed eligibility form called "Social Security Administration Review of Your Eligibility for Extra Help" (Form 1026-SM- REDE) and return the form within 30 days. If they don’t return the form, their Extra Help may end.
Source: q1medicare.com

Medicare Advantage Fact Sheet

Since 2006, Medicare has paid plans under a bidding process.  Plans submit “bids” based on estimated costs per enrollee for services covered under Medicare Parts A and B; all bids that meet the necessary requirements are accepted.  The bids are compared to benchmark amounts that are set by a formula established in statute and vary by county (or region in the case of regional PPOs).  The benchmarks are the maximum amount Medicare will pay a plan in a given area. If a plan’s bid is higher than the benchmark, enrollees pay the difference between the benchmark and the bid in the form of a monthly premium, in addition to the Medicare Part B premium.  If the bid is lower than the benchmark, the plan and Medicare split the difference between the bid and the benchmark; the plan’s share is known as a “rebate,” which must be used to provide supplemental benefits to enrollees.  Medicare payments to plans are then adjusted based on enrollees’ risk profiles.
Source: kff.org

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Medicare Hospital Compare Quality of Care

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Healthcare business news, research, data and events from Modern Healthcare

An OB-GYN who is the president-elect of the New Mexico Medical Society has had his license suspended by the state’s medical board for several alleged offenses, including drinking on the job and leaving a birthing mother unattended while having sex with another patient.
Source: modernhealthcare.com

Medicare Prescription Drug, Improvement, and Modernization Act

The bill came to a vote at 3 a.m. on November 22. After 45 minutes, the bill was losing, 219-215, with David Wu (D-OR-1) not voting. Speaker Dennis Hastert and Majority Leader Tom DeLay sought to convince some of dissenting Republicans to switch their votes, as they had in June. Istook, who had always been a wavering vote, consented quickly, producing a 218-216 tally. In a highly unusual move, the House leadership held the vote open for hours as they sought two more votes. Then-Representative Nick Smith (R-MI) claimed he was offered campaign funds for his son, who was running to replace him, in return for a change in his vote from “nay” to “yea.” After controversy ensued, Smith clarified no explicit offer of campaign funds was made, but that he was offered “substantial and aggressive campaign support” which he had assumed included financial support.
Source: wikipedia.org

Annual Statistical Supplement, 2011

Posted by:  :  Category: Medicare

Beginning January 1, 2006, upon voluntary enrollment in either a stand-alone PDP or an integrated Medicare Advantage plan that offers Part D coverage in its benefit, subsidized prescription drug coverage. Most FDA-approved drugs and biologicals are covered. However, plans may set up formularies for their drug coverage, subject to certain statutory standards. (Drugs currently covered in Parts A and B remain covered there.) Part D coverage can consist of either standard coverage or an alternative design that provides the same actuarial value. (For an additional premium, plans may also offer supplemental coverage exceeding the value of basic coverage.) Standard Part D coverage is defined for 2006 as having a $250 deductible, with 25 percent coinsurance (or other actuarially equivalent amounts) for drug costs above the deductible and below the initial coverage limit of $2,250. The beneficiary is then responsible for all costs until the $3,600 out-of-pocket limit (which is equivalent to total drug costs of $5,100) is reached. For higher costs, there is catastrophic coverage; it requires enrollees to pay the greater of 5 percent coinsurance or a small copay ($2 for generic or preferred multisource brand and $5 for other drugs). After 2006, these benefit parameters are indexed to the growth in per capita Part D spending (see Table 2.C1). In determining out-of-pocket costs, only those amounts actually paid by the enrollee or another individual (and not reimbursed through insurance) are counted; the exception is cost-sharing assistance from Medicare’s low-income subsidies (certain beneficiaries with low incomes and modest assets will be eligible for certain subsidies that eliminate or reduce their Part D premiums, cost-sharing, or both) and from State Pharmacy Assistance Programs. A beneficiary premium, representing 25.5 percent of the cost of basic coverage on average, is required (except for certain low-income beneficiaries, as previously mentioned, who may pay a reduced or no premium). For PDPs and the drug portion of Medicare Advantage plans, the premium will be determined by a bid process; each plan’s premium will be 25.5 percent of the national weighted average plus or minus the difference between the plan’s bid and the average. To help them gain experience with the Medicare population, plans will be protected by a system of risk corridors, which allow Part D to assist with unexpected costs and to share in unexpected savings; after 2007, the risk corridors became less protective. To encourage employer and union plans to continue prescription drug coverage to Medicare retirees, subsidies to these plans are authorized; the plan must meet or exceed the value of standard Part D coverage, and the subsidy pays 28 percent of the allowable costs associated with enrollee prescription drug costs between a specified cost threshold ($250 in 2006, indexed thereafter) and a specified cost limit ($5,000 in 2006, indexed thereafter).
Source: ssa.gov

2011 Medicare Part D Program Compared to 2010, 2009, 2008 and 2007

Pharmaceutical manufacturers will be required to provide certain beneficiaries access to discount prices for certain brand drugs purchased under Medicare Part D. The manufacturer discount prices will be equal to 50% of the plan’s negotiated price defined (minus any applicable dispensing fees). These discount prices must be applied prior to any prescription drug coverage or financial assistance provided under other health benefit plans or programs and after any supplemental benefits provided under the Part D plan. The discounted prices will be charged at the pharmacy (point-of-sale). The beneficiary will not have to do additional paperwork, etc. to receive the benefit. These manufacturer discount prices will be made available to Part D enrollees who are in the coverage gap or donut hole (they have reached or exceeded the initial coverage limit and have incurred costs below the annual out-of-pocket threshold). Medicare beneficiaries will not be eligible to receive these discount prices if they are enrolled in a qualified retiree prescription drug plan or are eligible for the low-income subsidy. The costs paid by manufacturers towards the negotiated prices of drugs covered under this manufacturer discount program shall be considered incurred costs for eligible beneficiaries and applied towards their out-of-pocket threshold. This means that the total negotiated retail drug price will be applied to the TrOOP and will count toward getting out of the doughnut hole.
Source: q1medicare.com