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Medicare Part D Glossary






Letter D
Jump to:
: : deductible : : doughnut (donut) hole
: : disability benefit : : dual eligibles
: : disenroll


deductible
The amount that the beneficiary must pay first, before coverage from the plan makes any of the payments. In Part D this is usually the first $310 of eligible drug expenses for the year.

disability benefit
A feature of some policies for the waiver of premium if the policyholder becomes permanently and totally disabled.

disenroll
When you disenroll, you end your coverage in a prescription drug or other health plan. Your plan can choose to disenroll you under specific circumstances.

doughnut (donut) hole
The gap in your coverage that spans between ordinary drug coverage and catastrophic drug coverage. In this gap, the Medicare beneficiary pays 100% of their prescription costs. According to the federal government, about 88% of Medicare beneficiaries who enrolled in a Medicare Part D plan do not have Donut Hole (or doughnut hole) coverage. The standard or model Part D coverage begins with a deductible of $310 followed by a co-pay of 25% on the next $2520 (you pay $630). Upon reaching the total medication costs of $2830 (with $940 out of pocket), coverage ceases and the beneficiary is 100% responsible for all costs during a "blackout period" known as the "Donut Hole" or "Coverage Gap", until a new spending tier, an additional $3610 out of pocket, is reached and coverage kicks in again at the "Catastrophic" level. See Coverage Gap.

dual eligibles
People eligible for both Medicare and Medicaid.


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Last updated on: 07/05/2009

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