Joined: Mar 2005
Posts: 6888
USA Medicare - donut hole closed?? new Health care bill
12/20/2009 at 10:10 PM
Well it seems that after all the dust settles one good thing comes out of it. The so called donut hole that elderly get themselves into is closed. The rest of the Usa citizens still get caught with it.
For those who do not know Medicare covers US seniors fairly well.
Co-pays is a term not used much here but it basically is like our coverage when we have to buy meds we pay some, the company pays some.
The donut hole is or was some time ago was a mount that Medicare would stop paying their portion. So when their out of pocket expense reach 2400 for that year- those on Medicare would pick up the slack until another program kicked in. That amount was about 4000.
So Lets say you were using a life saving med that you needed. Your co pay was like 25 bucks for three months . The insurers portion was 800. Those figure can change- they can go up and they can go down no matter the donut hole kicked in whenever that 2400 total was hit!
After the the first fill you were into it for 800( insurers portion) after 2 refills well you hit that donut hole. So your October refill( 4th) would cost you 825.
This assumes you have no other meds.
That donut hole came up very quickly for some. I have seen it as short as 7 days into the year. Yes after that gap between 2400 and 4000 is paid your co pays would go back to normal It was still a huge cost in the mean time.
Thanks to the AARP for pushing that through!