Handout: Medicare D



Handout: Medicare D

Prepared by Helen Chen, MD, Anna Chang MD, and Bree Johnston, MD

For more information about Medicare Part D, check out

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Reprinted with permission

Mrs. J’s monthly actual drug cost is $672 (not including her OTC meds). Her annual cost for OTC meds is $180. Her current annual drug cost is $8244.

Basic Medicare D plan:

• $250 deductible

• $32/month average premium

• No coverage for OTCs

No coverage in donut hole: pt is liable for all of drug costs up to maximum of $3600 in TROOP

Plan |A: Deductible? |B: Premiums |C. Pre-coverage gap co-pays or coinsurance (25% on basic plan) |TROOP pre-donut hole:

A+C |D: Cost in donut hole |Time in donut hole (until

TROOP = $3600, ie

A + C + D) |Time in catastrophic coverage |E: Post-donut hole costs |Total costs#: A+B+C+D+E |Potential annual savings | |Basic |$250 |$384

(32 x 12) |$500

Time pre-donut hole:

3.34 months |$750 |$2850 |4.24 months

(2850/672) |4.42 months |$148.51 |$4132.51 |$3931.49 | |Blue Cross Medicare Rx Gold |None |$408 |Time pre-donut hole: 3.34 months

129 x 3.34:

$430.86 |$430.86 |$3169.14 |4.71 months

(3169.14/672) |3.95

months |$509.55

(monthly co-pay x 3.95) |$4517.55 |$3546.45 | |AARP Medicare Rx |$250 |$117.60 |$136 x 3.34: 420.84 |$670.84 |$2929.16 |4.35 months (2929.16/672) |4.31 months |$586.16 |$4303.76 |$3760.24 | |*Costs are only estimates as plans handle months with partial coverage differently—some plans may elect to finish out the month of coverage even if the beneficiary technically would be in or out of the coverage gap.

#Does not include the out of pocket costs for her OTC meds, which are the same under each plan.

BOTTOM LINE: WIth any MEdICARE D PLAN SHE SPENDS ABOUT $4000-4500/year on prescription drugs, so she saves $3500-3900. the cheapest plans may not be those with the lowest premiums or no deductibles.

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