- Deductible:
will be increased by $5 to $325 in 2013 - Initial Coverage:
will increase from $2,930 in 2011 to $2,970 in 2013 - Catastrophic Coverage begins at:
will increase from $4,700 to $4,750 in 2013 - Coverage Gap (donut hole):
begins once you reach your Medicare Part D plan’s initial coverage limit ($2,970 in 2013) and ends when you spend a total of $4,750 in 2013.
In 2013, Part D enrollees will continue receive a 52.5% discount on the total cost of their brand-name drugs while in the donut hole. The full retail cost of the drugs will still apply to getting out of the donut hole even though 52.5% was paid for by others. Enrollees will pay a maximum of 79% co-pay on generic drugs while in the coverage gap. - Drug cost during Catastrophic Coverage:
will increase to greater of 5% or $2.65 for generic or preferred drug that is a multi-source drug and the greater of 5% or $6.60 for all other drugs in 2012
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There are people who don't realize that there is a Penalty for not having what is called creditable prescription coverage. Below is an excerpt from the official Medicare website describing this penalty.
What Is the Part D Late Enrollment Penalty? The late enrollment penalty is an amount added to your Part D premium. You may owe a late enrollment penalty if, at any time after your initial enrollment period is over, there is a period of 63 or more days in a row when you don't have Part D or other creditable prescription drug coverage. Note: If you get Extra Help, you don't pay a late enrollment penalty. 3 Ways to Avoid the Late Enrollment Penalty
The late enrollment penalty is calculated by multiplying 1% of the "national base beneficiary premium" ($32.34 in 2011) times the number of full, uncovered months you were eligible but didn't join a Medicare drug plan and went without other creditable prescription drug coverage. The final amount is rounded to the nearest $.10 and added to your monthly premium. The national base beneficiary premium may increase each year, so the penalty amount may also increase every year. Your Plan Will Tell You If You Owe a Penalty After you join a Medicare drug plan, the plan will tell you if you owe a penalty, and what your premium will be. You may have to pay this penalty for as long as you have a Medicare drug plan. If you had to pay a Part D late enrollment penalty before you turned 65, the penalty will be waived once you reach 65. Example: Mrs. Jones didn't join when she was first eligible-by May 15, 2007. She joined a Medicare drug plan between October 15-December 7, 2010, for an effective date of January 1, 2011. Since Mrs. Jones didn't join when she was first eligible and went without other creditable drug coverage for 43 months (June 2007-December 2010), she is charged a monthly penalty of $13.90 in 2011 ($32.34 national base rate premium X .01penalty rate X 43 months = $13.90). She pays this late enrollment penalty monthly in addition to her plan's monthly premium. For people about to apply for Medicare: one of the fundamental decisions they have to make is whether to use Original Medicare, Original Medicare and a Supplemental Plan or a Medicare Advantage Plan. They will also have to decide on a Medicare Part D Prescription Drug Plan. For more information on making these decisions contact Mark Scott.
If you are turning 65 you can apply for Medicare in the 3 months prior to the month of your birthday, the month of your birthday and the 3 months after the month of your birthday. Contact Mark Scott to get more information.
The Medicare Annual Enrollment Period has changed in 2011. The new enrollment period to make changes for 2012 is October 15, 2011 to December 7 2011. If you need to make changes during this period contact Mark Scott for more information.
I know a lot of people are concerned over the changes in New York State to the EPIC plan. The EPIC plan now requires members to have a Medicare Part D Prescription Drug Plan. You can contact Mark Scott to explain how the Part D plan works with EPIC.
Contact EPIC to get the details. http://www.health.state.ny.us/health_care/epic/
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