Doughnut Hole Coverage Explanation
If you’re enrolled in a prescription-drug plan under Part D of the federal Medicare health insurance program, a coverage gap known as the donut hole exists if your drug costs exceed a certain level.
The doughnut hole continues to shrink
In 2015 you will receive more discounts in the drug coverage gap.
- 55% off the cost of band name drugs
- 35% off generic drugs
Drug deductible increase in 2015
The maximum Part D annual drug deductible rises by $10 to $320.
- More plans will actually charge a deductible which will vary from $1 to $320 and fewer plans will wave the deductible.
Plans vary from state to state
The total number of plans throughout the U.S. will drop to 1,001 which is the lowest since Part D began.
- Monthly premiums range from a low of $12.60 to a high of $171.90 with an average of $38.83.
Look at your copays
It is important to look beyond your premium and check your copay.
- If your copay, for example, doubles from let's say $50 to $100 this could be more important than your increase in premium.
Drug restrictions
Medicare Part D plans have formulas that list which drugs are covered and the cost-sharing requirements. Some Part D plans also require prior authorization before you can fill certain prescriptions or might require you to try similar lower-cost drugs or generic drugs before a plan will cover a more expensive prescribed drug. There may also be quantity limits on how much medication you can get at a time.