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Medicare’s Annual Enrollment Period began on October 15. It lasts until December 7 this year. During this time you may make adjustments to your Medicare Part D plans if you wish.
A great deal of rhetoric has been applied to the popular Medicare Part D plans in recent years. Traditional Medicare only pays for prescription drugs under very special circumstances. It will not pay for most of the prescription medication you get from your pharmacy. If you want insurance help with your prescriptions at your pharmacy, you will need to enroll in the optional Medicare D program.
The Medicare D program was first introduced when George Bush was president. It was a source of great contention during the health care reform debates. In this post I will share some of the changes that have occurred to Medicare D since it first arrived.
DEDUCTIBLE
This is the amount that you must pay for your prescription drugs before you will get any help from your insurance company. Insurance companies are allowed
to have lower deductibles than these limits but no higher. In 2006 the deductible was only $ 250. In 2012 the deductible is $ 320.
INITIAL COVERAGE LIMIT
This is the amount of the retail cost for drugs that your insurance company would help you with after you have paid whatever plan deductible you elected. In 2006 the insurance company would help with $ 2,250 of prescription drugs. In 2012, Medicare D will help with $ 2,930 of prescription drugs after you have paid your plan’s deductible.
Once you have used all your initial coverage benefit, you enter the “Donut Hole” that so many politicians have talked about. During the “Donut Hole” your insurance benefits are minimal. The Patients Protection and Affordable Care Act requires pharmaceutical companies to reduce their retail costs by 50% on Brand Name drugs for those who have paid enough in prescription costs to enter the “Donut Hole.”
If you are in your “Donut Hole” and your drug is a generic drug, you will get a percentage discount off the retail cost of your drug at your pharmacy.
CATASTROPHIC COVERAGE
After you have paid this amount in prescription costs for the year, your Medicare D plan will pay most of your prescription drug costs. All you will have to pay is
a nominal co-pay.
When the Medicare Part D plan was first authorized in 2006 the catastrophic limit was only $ 5100.00. For 2012 the catastrophic limit will be $ 6,657.50.
Whether or not you like these numbers is immaterial. If you are enrolled in Medicare, Medicare Part D is your only option for prescription drug coverage. If you want to see where these numbers came from or more numbers about Medicare Part D click here.
