2010 Donut Hole Calculation Summary: | |
Summary of the annual retail cost of your drugs:
|
|
Percentage of Generic vs. Brand drug purchases used: | |
No factor 100% Responsible in Gap | |
You will enter the Coverage Gap (Donut Hole): | in April |
You will exit the Coverage Gap (Donut Hole): | with start of new plan year |
Your total annual Out-of-Pocket Costs without premium: | $3,952.50 |
Your total annual Out-of-Pocket Costs without premium and with the 2010 $250 Rebate for persons not receiving "Extra Help" Read More... |
$3,702.50 |
2010 Donut Hole Calculation Details | |||||||
Month |
Plan Phase |
Who Pays | Total Retail |
||||
You | Plan | Mfgr | Gov | ||||
$$ | 1: Jan | Initial Coverage | $643.75 | $1,931.25 | $0.00 | $0.00 | $2,575.00 |
You are in the Initial Coverage Phase. Your costs so far $643.75. | |||||||
$$ | 2: Feb | Initial Coverage | $25.00 | $75.00 | $0.00 | $0.00 | $2,675.00 |
You are in the Initial Coverage Phase. Your costs so far $668.75. | |||||||
$$ | 3: Mar | Initial Coverage | $25.00 | $75.00 | $0.00 | $0.00 | $2,775.00 |
You are in the Initial Coverage Phase. Your costs so far $693.75. | |||||||
$$ | 4: Apr | Initial Coverage | $13.75 | $41.25 | $0.00 | $0.00 | $2,830.00 |
You are in the Initial Coverage Phase. Your costs so far $707.50. | |||||||
$$$ | 4: Apr | Donut Hole | $445.00 | $0.00 | $0.00 | $0.00 | $3,275.00 |
You entered the Coverage Gap (Donut Hole) in April. Your costs so far $707.50. For plan year 2010 only, Medicare Beneficiaries who are not receiving "Extra Help" and reach the Coverage Gap will receive a $250 rebate. Read More... | |||||||
$$$ | 5: May | Donut Hole | $100.00 | $0.00 | $0.00 | $0.00 | $3,375.00 |
You are still in the Donut Hole. Your costs so far $707.50. | |||||||
$$$ | 6: Jun | Donut Hole | $100.00 | $0.00 | $0.00 | $0.00 | $3,475.00 |
You are still in the Donut Hole. Your costs so far $707.50. | |||||||
$$$ | 7: Jul | Donut Hole | $1,700.00 | $0.00 | $0.00 | $0.00 | $5,175.00 |
You are still in the Donut Hole. Your costs so far $707.50. | |||||||
$$$ | 8: Aug | Donut Hole | $100.00 | $0.00 | $0.00 | $0.00 | $5,275.00 |
You are still in the Donut Hole. Your costs so far $707.50. | |||||||
$$$ | 9: Sep | Donut Hole | $100.00 | $0.00 | $0.00 | $0.00 | $5,375.00 |
You are still in the Donut Hole. Your costs so far $707.50. | |||||||
$$$ | 10: Oct | Donut Hole | $500.00 | $0.00 | $0.00 | $0.00 | $5,875.00 |
You are still in the Donut Hole. Your costs so far $707.50. | |||||||
$$$ | 11: Nov | Donut Hole | $100.00 | $0.00 | $0.00 | $0.00 | $5,975.00 |
You are still in the Donut Hole. Your costs so far $707.50. | |||||||
$$$ | 12: Dec | Donut Hole | $100.00 | $0.00 | $0.00 | $0.00 | $6,075.00 |
You are still in the Donut Hole. Your costs so far $707.50. | |||||||
Summary |
Who Pays | Total Retail |
|||||
You | Plan | Mfgr | Gov | ||||
Totals without premium: | $3,952.50 | $2,122.50 | $0.00 | $0.00 | $6,075.00 | ||
Totals without premium and with rebate: | $3,702.50 | $2,122.50 | $0.00 | $6,075.00 | Reflects the $250 rebate** | ||
Notes: *Copayments do not influence when you will enter and leave the Donut Hole (which is based on plan’s negotiated retail drug costs). It will only affect your out-of-pocket costs. ** For plan year 2010 only, Medicare Beneficiaries who are not receiving "Extra Help" and reach the Coverage Gap (Donut Hole) will receive a one-time, tax-free $250 rebate. You can expect to receive your rebate check automatically, approximately 45 days after you reach the Coverage Gap. There is no paperwork to be filled out. Read More... | |||||||
Legend: | |||||||
$$$ | You are responsible for 100% of your prescription (Rx) costs. This occurs during the Initial Deductible phase of coverage. (Many plans do not have an initial deductible or exclude low-cost generic drugs from the deductible. ) | ||||||
$$ | You share your prescription (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 copayment on enhanced plans. | ||||||
$ | You pay a small fraction of your prescription (Rx) costs. This occurs in Catastrophic Coverage. You pay 5% of your medication costs or $2.50 for generics or $6.3 for brand drugs (whichever is higher). |
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