November 18, 2008
Medicare Prescriptions and the Doughnut Hole
The Washington Post provides facts about Medicare Part D:
Facts about Medicare Part D prescription coverage:
- Under Medicare Part D, elderly and disabled Medicare benficiaries can enroll in a private drug plan that is largely subsidized by the federal government. Before the benefit began in 2006, that drug coverage was available only though private supplemental plans.
- Medicare Part D contains a gap in coverage often described as "the doughnut hole." Patients in the coverage gap have to pay full cost out of pocket for their drugs,
- Under 2008 Medicare rules, once the cost of a patient's prescriptions reaches $2,510, including the amount the patient pays and the amount his or her insurer pays, the patient is in the coverage gap and must cover the next $3,850 in spending on his or her own. After that point, Medicare coverage resumes.
- In 2009, the coverage gap begins at $2,700 in spending. The gap ends after the member has spent $4,350.
- Health insurers that do significant amounts of Medicare Part D business include Cigna Corp., WellPoint Inc., Universal American Corp., WellCare Health Plans Inc. and Health Net Inc. Insurers compete for Medicare business in a bidding system, with those who offer prices below a government standard being chosen.
- Humana Inc. will no longer participate in Part D coverage after Jan. 1, 2009.
November 18, 2008 | Permalink
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