Medicare Part D: Decisions, decisions, decisions

Medicare prescription drug coverage should save many people some money, but it puts a new burden on beneficiaries to be smart shoppers.

Part D prescription drug coverage is the biggest expansion of the Medicare program since it started in 1965. It's long overdue. Prescription drugs were an afterthought 40 years ago; now so much of medical care depends on them. And research has shown that people tend to skimp on needed medications unless they have some insurance coverage.

The price tag has been the chief obstacle. Part D is expected to cost a total of $724 billion in its first decade of existence, with federal tax revenues covering about 80% of the tab. To put that into perspective, total annual Medicare spending stands at about $375 billion as of 2005.

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