We have updated our 2011 PDP-Planner (or Donut Hole Calculator) to include the model plan features for 2011. We have several example online and you can click here for an example of a Medicare beneficiary with relatively high monthly prescription drug costs (a retail drug cost of $800 per month).
In this example, this Medicare beneficiairy can anticipate entering the 2011 Donut Hole in April 2011 when their 2011 Initial Coverage Limit of $2,840 is exceeded.
This same example person will exit the 2011 Donut Hole when their True Out of Pocket Costs (TrOOP) exceed $4,550.
In our example, this person’s total out of pocket drug expenses for 2011 without the new 2011 Coverage Gap discount would be approximately $4,696 (assuming a 25% co-insurance as Initial Coverage Phase cost-sharing).
Of the total expenses, $3,840 of the 2011 drug purchases occur in the Coverage Gap and this person can expect to receive a 7% discount on their generic drug purchases and a 50% discount on their brand name drug purchases.
If this person’s drug purchases were all generic drugs (100% generics), their maximum out-of-pocket expenses would be reduced by $268.80.
If, on the other hand, this person’s purchases where all brand name prescription drugs, their total out-of-pocket cost would be reduced by $1,920.
You can change the $800 value in our example to your own prescription spending and the deductible (which is set at $0) to see a preview of your own 2011 coverage.
Still not sure what all these numbers mean to you? Click here and let us know.
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