PREVIEW OF FEATURE ARTICLE
Down the Donut Hole: The Medicare Coverage Gap
One of the most confusing Medicare provisions is the prescription drug coverage gap, often
called the "donut hole." It may be clearer if you consider the gap within the annual "lifecycle" of
Medicare Part D Prescription Drug Coverage. This also applies to drug coverage that is
integrated into a Part C Medicare Advantage Plan.
Annual deductible. Prescription drug plans typically have an annual deductible not
exceeding $405 in 2018. Before reaching the deductible, you will pay the full cost of your
prescriptions, although you may receive negotiated discounts. Initial coverage period. After you meet the
annual deductible, your plan will pay a portion of your prescription drug costs, and you will
typically have a copayment or coinsurance amount. A 25% coinsurance amount is the
standard coverage required by Medicare, but most plans have different levels or "tiers" of
copayments or coinsurance for different types of drugs.
Coverage gap. When you and your plan combined have spent a specified amount on
drugs for the year ($3,750 in 2018), you enter the coverage gap. In 2018, you pay 35% of
your plan's price for covered brand-name prescription drugs and 44% of the price for
generic drugs. The gap is closing over the next two years.
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MESSAGE FROM PETER GALLAGHER - FALL 2018 ISSUE
I trust that you enjoyed the Fall weather with family and friends.
Last month, the URPG team was featured in a video that will be uploaded to our
website. The video contains a 90 second introduction to what we offer our clients
at URPG. When the video is completed, we will share it with you for your review.
We value your feedback.
We recently held another Chinese cooking class which has continued to be
a lot of fun. Please contact our office if you are interested in attending our next
As the year winds down, we will be in touch with you to complete a year-end
account review. Please enjoy the topics that we have chosen in this version of our URPG
newsletter. If you have any suggestions for future topics, please let us know.
View the full URPG Newsletter - Fall 2018 (Nov) Issue