What is the Medicare Donut Hole?

prescription drug, weekly pill container

For older Americans, the Medicare program is one of the most successful in history, but this healthcare delivery system is not without its flaws. While Medicare has long helped senior citizens get coverage for routine doctor visits, specialty care, and hospital stays, until recently prescription drugs were not part of the mix.

That all changed when Medicare Part D was introduced. As the name implies, Medicare Part D was designed to assist senior citizen beneficiaries with the high cost of prescription drugs, so they could stay healthier and improve their medication compliance.

Even so, the Medicare Part D program is far from perfect, and one of the biggest obstacles to quality care is the so-called “donut hole.” The Medicare donut hole is actually a potentially costly coverage gap, a period of time during which Medicare beneficiaries can incur thousands of dollars in uncovered medication costs.

We can help you choose the right Medicare gap coverage option for you. Contact Steinlage Insurance Agency today!

How the Medicare Part D Coverage Gap Affects You

The Medicare prescription drug coverage gap begins once you have reached a specific threshold in drug costs, and that monetary threshold is adjusted on an annual basis. While your Medicare Part D prescription plan pays at least 75% of your drug costs during the initial phase, once the coverage gap kicks in, your drug costs could rise substantially.

Once those increased costs take effect, you may need to continue paying those high prescription drug costs until you reach the catastrophic phase of your Medicare Part D coverage. When you enter the catastrophic phase of your coverage, virtually all of your prescription drug costs will be covered, but not before you have paid potentially thousands of dollars out of your own pocket.

That is why it is so important to choose a Medicare Part D plan that addresses the donut hole and provides coverage through this coverage gap. Not all plans are the same, and a growing number of Medicare Part D options provide coverage designed to address high out-of-pocket costs.

What To Do About the Medicare Donut Hole

If you want to make the most of your Medicare Part D coverage and keep your out-of-pocket costs to a minimum, you need to take the Medicare prescription drug coverage gap seriously.

If you choose your Medicare Part D coverage with care, you can greatly reduce the impact the coverage gap has on yourself and your family, so you can stay financially solvent all year long. Unfortunately, it is not easy to find a plan that will keep you, and your wallet, healthy, but you will be happy to know that professional help is available.

Medicare Insurance Agents

Steinlage Insurance Agency can help you choose the Medicare Part D coverage that is right for you and your spouse, including hole coverage that protects you from the potentially ruinous cost of staying healthy. We will start by reviewing the prescription medications you are taking and the health challenges you have faced, then we will help you choose a Medicare Part D plan that includes comprehensive hole coverage along with coverage for doctor visits, hospital stays, medical tests and all the other essentials you need.

We know that finding the right Medicare insurance agent is the key to keeping costs down, especially in the donut hole, and we work with each of our clients to choose the best possible plan at the lowest possible cost.

Contact us today!