Many Medicare beneficiaries are confused by the Part D coverage gap (also know as the “doughnut hole); this is why it is important to understand how the ‘doughnut hole’ works.
How do the Drug Payment Stages work?
You share costs with the plan, usually as copays until the combined total hits $2,840 (2011). This figure can vary by plan. This stage is sometimes called the “initial coverage period.”After you reach $2,840 (2011) in total drug costs, you pay 93% of the cost of generic drugs and about 50% of the cost of most brand-name drugs until your yearly drug costs hit $4,550 (2011). During this period you pay most of the costs, your plan pays a little. This is the Coverage Gap or Doughnut hole.
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