Medicare Part D - Closing The Donut Hole!


I read a Medicare Rights Center Blog post as well as other articles from different sources. So I thought I’d share this relevant information I found about closing the "Donut Hole!” 
Note: For those of you that may be unfamiliar with the term “Donut Hole,” it is also known as a “Coverage Gap" for Part D prescription drug plans.

So you may be thinking what does that mean to me. For brand name medications (only), starting in 2019, the donut hole has closed, which is one year earlier than initially planned. However the coverage gap for generic drugs will still close in 2020 as originally planned. Even with the Donut Hole closing, that still does not mean you won’t have to pay for medications once they get to this drug payment stage.

Here is a little background:
When Part D first started in 2006, the Part D drug plan had a gap in coverage. Drug plans did not pay anything toward the cost of drugs in the donut hole so beneficiaries were stuck with the tab for the entire cost. 

"When Congress expanded Medicare to cover prescription drugs by adding Part D, they built in a coverage gap that made drug coverage disappear when people reached a certain spending level, then reappear when they hit another threshold. This donut hole left many people with Medicare struggling to afford their medications for at least part of the year.”1

However in 2012, the Affordable Care Act made changes and implemented discounts for the Donut Hole which reduced the impact to Part D plan members. Each year, those discounts slowly reduced the out of pocket percentages that members were required to pay during the Donut Hole. After 2020, drug plan members will no longer face an increased percentage of the cost for medications during the Donut Hole. They will pay 25% of the cost for any prescribed medication from the time they meet the deductible until reaching the out-of-pocket spending limit. 


Click on web link below to read the entire Medicare Rights Center Blog post:

https://blog.medicarerights.org/closing-donut-hole-means-matters/


1. Source: Medicare Rights Center Blog
https://blog.medicarerights.org/closing-donut-hole-means-matters/

2. Source: 65 Incorporated 
https://www.65incorporated.com/topics/medicare-part-d-prescription-drug-plans/medicare-donut-hole-closing/

3. Additional Source: KFF
https://www.kff.org/medicare/issue-brief/closing-the-medicare-part-d-coverage-gap-trends-recent-changes-and-whats-ahead/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews