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2010 PDP-Planner:
Medicare Part D Doughnut Hole Calculator
| 2010 Doughnut Hole Calculation Summary: |
|
| You will enter the Coverage Gap (Doughnut Hole): |
in April |
| You will exit the Coverage Gap (Doughnut Hole): |
in September |
| Your total annual Out-of-Pocket Costs without premium: |
$4,696.38
|
| 2010 Doughnut Hole Calculation Details |
| |
Month |
Plan Phase |
Who Pays |
Total
Retail |
Explanation |
| You |
Plan |
Gov |
| $$ | 1: Jan | Initial Coverage |
$200.00 |
$600.00 |
$0.00 |
$800.00 |
You are in the initial coverage phase. Your costs so far $200.00. |
| $$ | 2: Feb | Initial Coverage |
$200.00 |
$600.00 |
$0.00 |
$1,600.00 |
You are in the initial coverage phase. Your costs so far $400.00. |
| $$ | 3: Mar | Initial Coverage |
$200.00 |
$600.00 |
$0.00 |
$2,400.00 |
You are in the initial coverage phase. Your costs so far $600.00. |
| $$ | 4: Apr | Initial Coverage |
$107.50 |
$322.50 |
$0.00 |
$2,830.00 |
You are in the initial coverage phase. Your costs so far $707.50. |
| $$$ | | Doughnut Hole |
$370.00 |
$0.00 |
$0.00 |
$3,200.00 |
You entered the coverage gap (doughnut hole) in April. Your costs so far $1,077.50. |
| $$$ | 5: May | Doughnut Hole |
$800.00 |
$0.00 |
$0.00 |
$4,000.00 |
You are still in the doughnut hole. Your costs so far $1,877.50. |
| $$$ | 6: Jun | Doughnut Hole |
$800.00 |
$0.00 |
$0.00 |
$4,800.00 |
You are still in the doughnut hole. Your costs so far $2,677.50. |
| $$$ | 7: Jul | Doughnut Hole |
$800.00 |
$0.00 |
$0.00 |
$5,600.00 |
You are still in the doughnut hole. Your costs so far $3,477.50. |
| $$$ | 8: Aug | Doughnut Hole |
$800.00 |
$0.00 |
$0.00 |
$6,400.00 |
You are still in the doughnut hole. Your costs so far $4,277.50. |
| $$$ | 9: Sep | Doughnut Hole |
$272.50 |
$0.00 |
$0.00 |
$6,672.50 |
You are still in the doughnut hole. Your costs so far $4,550.00. |
| $ | | Catastrophic Coverage |
$26.38 |
$79.13 |
$422.00 |
$7,200.00 |
You exited the coverage gap (doughnut hole) in September and are now in the catastrphic coverage. We have used 5% to calculate your costs. The actual calculation is $2.5 for generics, $6.3 for brands or 5% which ever is higher. Your costs so far $4,576.38. |
| $ | 10: Oct | Catastrophic Coverage |
$40.00 |
$120.00 |
$640.00 |
$8,000.00 |
You will remain in catastrophic coverage until the end of the year. Your costs so far $4,616.38. |
| $ | 11: Nov | Catastrophic Coverage |
$40.00 |
$120.00 |
$640.00 |
$8,800.00 |
You will remain in catastrophic coverage until the end of the year. Your costs so far $4,656.38. |
| $ | 12: Dec | Catastrophic Coverage |
$40.00 |
$120.00 |
$640.00 |
$9,600.00 |
You will remain in catastrophic coverage until the end of the year. Your costs so far $4,696.38. |
| Totals without premium: |
$4,696.38 |
$2,561.63 |
$2,342.00 |
$9,600.00 |
|
Notes:
* Co-payments do not influence when you will enter and leave the doughnut hole (which is based on retail medication costs). It will only effect your out-of-pocket costs. |
| Legend: |
| $$$ |
You are responsible for 100% of your Rx costs. This occurs during the deductible and in the coverage gap (doughnut hole) unless you have a plan with full doughnut hole coverage. |
| $$ |
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. |
| $ |
You pay a small fraction of your Rx costs. This occurs in catastrophic coverage. You pay 5% of your medication costs or $2.5 for generics or $6.3 for brand drugs (which ever is higher). |
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 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: 07/05/2009
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Life Insurance plays an important role in your families financial stability.
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