You were responsible for the first $275Â (Deductible) of prescription drug expenses
You are now responsible for the first $295Â (Deductible) of prescription drug expenses
You paid 25% of the next $2,235 of prescription drug expenses (25% of $2,235 = $558.75)
You will pay 25% of the next $2,405 of prescription drug expenses (25% of $2,405 = $601.25)
Donut hole "threshold" = $2,510 That is, what you and the plan have spent ($275 + $2,235 = $2,510)
Donut hole "threshold" = $2,700 That is, what you and the plan have spent ($295 + $2,405 = $2,700)Â
You paid 100% of the next $3,216.25 (The "donut hole")
You will pay 100% of the next $3,453.75 (The "donut hole")
"Catastrophic coverage" began after you have spent $4,050 (this is your total out-of-pocket spending requirement) ($275 + $558.75 + $3,216.25 = $4,050) Or, put another way: Total spending (you and the plan) for catastrophic coverage = $5726.25 ($275 + $2,235+ $3,216.25 = $5,726.25)
"Catastrophic coverage" begins after you have spent $4,350 (this is your total out-of-pocket spending requirement) ($295 + $601.25 + $3,453.75 = $4,350) Or, put another way: Total spending (you and the plan) for catastrophic coverage = $6,153.75 ($295 + $2,405 + $3,453.75 = $6,153.75)
Minimum cost sharing in catastrophic benefit period:Â $2.25 (generic) and $5.60 (brand)
Minimum cost sharing in catastrophic benefit period:Â $2.40 (generic) and $6.00 (brand)
Medicare beneficiaries, their families, and their advocates can attest that the current market-based system for providing Medicare prescription drug coverage through private insurance companies does not work.  Since 2006, when the Medicare Part D program began, the private insurance companies that offer Medicare drug plans have continued to shift more of the costs of coverage onto Medicare beneficiaries. They have also taken steps to rid themselves of the most costly plan enrollees, those who are eligible for the Part D low-income subsidy (LIS) that helps defray premiums and cost-sharing for people with limited incomes and resources...Read More
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