Gap In Medicare
Coverage Hitting Seniors Enrolled in Part D - What Happened? Donut
Hole Hits Drug Plan Recipients with Extra Costs
July 31st 2006
|
 |
|
Donut Hole |
|
Some Medicare patients are left paying large sums of money because of a
gap in Medicare coverage called the “doughnut hole”. Once a patient
reaches a threshold in prescription drug expenditures they are
responsible for 100 percent of the cost. This threshold is reached
between $2,250 and $5,100 of the total drugs cost (not the out of pocket
expense). After the drug costs reach $5,100, Medicare will pay 95
percent of the expenses.
Many Medicare beneficiaries were unaware of this doughnut hole according
to a report by the Baltimore Sun. Even if patients are aware of the
doughnut hole, many of them are only keeping track of their
out-of-pocket expenses and not the total cost of the drugs. The donut
hole is reached when the total cost of the drugs reaches $2,250, not
when the recipients out of pocket expense reach $2,250. Read below for
more.
After the total cost of the drugs used by the patient reaches $2,250,
the recipient is completely responsible for the cost of the drugs. Now
you, the recipient, is responsible for 100 percent of your drug coverage
until the total cost of the drugs reaches $5,100. After that, Medicare
will pick-up 95 percent of the bill. This means you could end up paying
$2,650 ($5,100 - $2,250) inside the donut hole.
The New York Times reports that many beneficiaries are upset about this.
When the program first started, few people were concerned because the
donut-hole threshold was not reached by anyone. But now, midyear, some
patients are feeling the pinch.
Some advocacy groups have complained about the Medicare Part D program.
They claimed it was created to benefit drug and insurance companies.
Before Part D, many recipients were purchasing their drugs from Canadian
pharmacies at a discounted rate.
Under Medicare Part D, the drug companies are able to charge full
price. The Federal government (i.e. the taxpayers) picks up the
difference. There is a small out of pocket expense for the recipient
until the donut hole is reached. Everyone seems to be happy with the
program except anti-tax groups and recipients who fall into the donut
hole.
Dan Wilson
Best Syndication
Health
Insurance
Keywords and misspellings: helth ensurance quotes
find lowest price medcare medecare medacare
|
