A few notes to help with the understanding of the 2007 Medicare Part D Plan chart above.
- Plan Name: This is the official plan name from CMS
- Deductible: This is the $265 deductible that was presented in the CMS Standard Plan. Many provider's plans do not have a deductible, however the premium may be higher.
- Co-Pay Tiered Coverage: This is the portion of the plan where the provider and the beneficiary share the costs. Generally speaking, the beneficiary pays $798.75 ($265 + ($2135 x 25%)) out-of-pocket before moving to the Coverage Gap (Donut Hole) portion of the plan. Most of the plans provide a Tiered Drug List for this portion of the plan. In our chart, Yes: means that the plan uses a tiered drug list, therefore, drugs are organized into tiers and you pay a co-payment or co-insurance based on the tier. For Example: Tier 1 drugs: you pay a $5 co-payment, Tier 2: you pay $10, Tier 3: you pay $30. Each plan is different as to which drugs fall into which tiers and how much you pay per Tier. If None is shown in our chart, this means that a 25% co-insurance is applied (as in the CMS Standard Plan).
- Coverage Gap the Donut Hole: In the CMS Standard Plan, the beneficiary must pay the next $3051.25 in drug costs (the Donut Hole). Many provider's plans cover the costs that fall into this category for an additional premium. In our chart, you will see one of the following None: you must pay the $3051.25; Generics Only: Generics are covered, but you must pay for Brand Drugs up to $3051.25; Generic & Brand Drugs: Both are covered by the plan, you are only responsible for non-preferred brand drugs.
- Benefit Type: Basic means that this plan follows the standard CMS plan. Enhanced means that this plan has features above and beyond the standard CMS plan.
- Plan ID: This is the unique id for this particular plan.
Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, we cannot guarantee the accuracy of this information. Through the application process we will provide you with the most up-to-the-minute information/pricing.
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