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2007 PDP-Planner:
Medicare Part D Doughnut Hole Calculator
| 2007 Doughnut Hole Calculation Summary: |
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| You will enter the Coverage Gap (Doughnut Hole): |
in January |
| You will exit the Coverage Gap (Doughnut Hole): |
in October |
| Your total annual Out-of-Pocket Costs without premium: |
$3,871.25
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| 2007 Doughnut Hole Calculation Details |
| |
Month |
Plan Phase |
Who Pays |
Total
Retail |
Explanation |
| You |
Plan |
Gov |
| $$ | 1: Jan | Initial Coverage |
$600.00 |
$1,800.00 |
$0.00 |
$2,400.00 |
You are in the initial coverage phase. Your costs so far $600.00. |
| $$$ | | Doughnut Hole |
$175.00 |
$0.00 |
$0.00 |
$2,575.00 |
You entered the coverage gap (doughnut hole) in January. Your costs so far $775.00. |
| $$$ | 2: Feb | Doughnut Hole |
$100.00 |
$0.00 |
$0.00 |
$2,675.00 |
You are still in the doughnut hole. Your costs so far $875.00. |
| $$$ | 3: Mar | Doughnut Hole |
$100.00 |
$0.00 |
$0.00 |
$2,775.00 |
You are still in the doughnut hole. Your costs so far $975.00. |
| $$$ | 4: Apr | Doughnut Hole |
$500.00 |
$0.00 |
$0.00 |
$3,275.00 |
You are still in the doughnut hole. Your costs so far $1,475.00. |
| $$$ | 5: May | Doughnut Hole |
$100.00 |
$0.00 |
$0.00 |
$3,375.00 |
You are still in the doughnut hole. Your costs so far $1,575.00. |
| $$$ | 6: Jun | Doughnut Hole |
$100.00 |
$0.00 |
$0.00 |
$3,475.00 |
You are still in the doughnut hole. Your costs so far $1,675.00. |
| $$$ | 7: Jul | Doughnut Hole |
$1,700.00 |
$0.00 |
$0.00 |
$5,175.00 |
You are still in the doughnut hole. Your costs so far $3,375.00. |
| $$$ | 8: Aug | Doughnut Hole |
$100.00 |
$0.00 |
$0.00 |
$5,275.00 |
You are still in the doughnut hole. Your costs so far $3,475.00. |
| $$$ | 9: Sep | Doughnut Hole |
$100.00 |
$0.00 |
$0.00 |
$5,375.00 |
You are still in the doughnut hole. Your costs so far $3,575.00. |
| $$$ | 10: Oct | Doughnut Hole |
$275.00 |
$0.00 |
$0.00 |
$5,650.00 |
You are still in the doughnut hole. Your costs so far $3,850.00. |
| $ | | Catastrophic Coverage |
$11.25 |
$33.75 |
$180.00 |
$5,875.00 |
You exited the coverage gap (doughnut hole) in October and are now in the catastrphic coverage. We have used 5% to calculate your costs. The actual calculation is $2.15 for generics, $5.35 for brands or 5% which ever is higher. Your costs so far $3,861.25. |
| $ | 11: Nov | Catastrophic Coverage |
$5.00 |
$15.00 |
$80.00 |
$5,975.00 |
You will remain in catastrophic coverage until the end of the year. Your costs so far $3,866.25. |
| $ | 12: Dec | Catastrophic Coverage |
$5.00 |
$15.00 |
$80.00 |
$6,075.00 |
You will remain in catastrophic coverage until the end of the year. Your costs so far $3,871.25. |
| Summary |
Who Pays |
Total
Retail |
Explanation |
| You |
Plan |
Gov |
| Totals without premium: |
$3,871.25 |
$1,863.75 |
$340.00 |
$6,075.00 |
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Notes:
* Co-payments do not influence when you will enter and leave the Doughnut Hole (which is based on plan’s negotiated retail drug costs). It will only effect your out-of-pocket costs.
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| Legend: |
| $$$ |
You are responsible for 100% of your Rx costs. This occurs during the deductible and in the coverage gap (doughnut hole) unless you have a plan with full doughnut hole coverage.
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| $$ |
You share your Rx costs with your Medicare Part D plan provider. During the initial coverage phase, you are responsible for 25% of your medication costs (basic or standard plans) or a co-payment on enhanced plans.
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| $ |
You pay a small fraction of your Rx costs. This occurs in catastrophic coverage. You pay 5% of your medication costs or $2.15 for generics or $5.35 for brand drugs (which ever is higher).
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Calculators Available:
Plan Out of Pocket Cost Calculators:
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Doughnut Hole Calculators:
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This Q1Medicare.com Doughnut Hole calculator is based on the 2007 CMS Standard Benefit Medicare Part D plan and designed to estimate when a Medicare Part D beneficiary would (1) enter and exit the coverage gap and (2) the potential prescription costs for the year. The actual time when a Medicare Part D beneficiary enters the Doughnut Hole and the costs associated with the plan may vary depending on the chosen Medicare Part D plan.
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Last updated on: 05/26/2010
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Life Insurance plays an important role in your families financial stability.
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