PostHeaderIcon Medicare Prescription Benefits in 2010


The Medicare prescription drug plan has four phases:

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1. Depending on your policy you may have to pay up to the first $310 of your drug costs. This is known as the deductible.

2. During the initial coverage phase, your drug plan pays 75% of the covered prescription drug costs (after your deductible is met) and you pay 25% until the total drug costs (including your deductible) reach $2,830.

3. Once you reach $2,830 in total drug costs, you will be in the coverage gap, and you must pay the full cost of prescription drugs until your total out-of-pocket cost reaches $4,550. This annual out-of-pocket spending amount includes your yearly deductible and co-pay amounts. ($1,720)

4. When you spend more than $4,550 out-of-pocket, the coverage gap ends and your drug plan pays most of the costs of your covered drugs for the remainder of the year. You will be responsible for a co-pay of $2.40 for each generic drug and $6.00 for other drugs (or 5%, whichever is higher). This is known as catastrophic coverage.

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It is important to understand that your Part D prescription drug plan may differ from the standard Medicare prescription plan design, only if the plan offers you a better benefit. For example, your plan can eliminate or lower the amount of the deductible. And, your plan can pay for generic or brand name medications in the coverage gap.

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Health Reform and Medicare Part D

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The Patient Protection and Affordable Care Act signed into law on March 23, 2010 makes several changes to Medicare Part D to reduce your out-of-pocket costs when you reach the gap in coverage, including:
1. In 2010, if you have expenses in the coverage gap, you will receive a $250 rebate from Medicare.

2. Beginning in 2011, if you reach the donut hole, you will be given a 50% discount on the total cost of brand name drugs while in the gap.
3. Medicare will phase in additional discounts on the cost of both brand name and generic drugs.

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By 2020, these changes will effectively close the coverage gap and your responsibility will be 25% of the costs.

2 Responses to “Medicare Prescription Benefits in 2010”

  • Annett Helminiak says:

    What’s Up! Just wanted to tell you that you own a wonderful little blog and I want you are aware how nice it looks. Will return frequently.

  • Donald Perry says:

    The American Medical Association urges Congress to preserve health care for seniors by blocking a sizeable Medicare cut to doctors. If nothing is done by December 1, doctors will be receiving 25% less from Medicare, which will have negative repercussions for the elderly health care, the AMA (American Medical Association) announced today.

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