Toni:

Last year, the 2017 Medicare and You handbook did not include the 2017 Part D deductibles and “Donut Hole” costs, and I got in the “famous” Medicare donut hole this March.

I know it is only September, but I would like to get prepared and really cannot find the answer online or at the Medicare.gov website. Please inform me what the 2018 Medicare Part D costs will be.  I look forward to what you have to say.

Karen, Dallas, TX

 

Karen:

You are correct that the 2017 Medicare and You handbook did not have the 2017 Part D deductibles or out of pocket maximums.  I’ve looked online and the Medicare handbook has not been released yet.  I do not foresee it being updated until Sunday, October 1st.

But guess what??  For the Toni Says® Medicare newspaper column readers, we have a big surprise!  I know what the Medicare Part D cost and copays and Donut Hole will be for 2018.

How the various 2018 Medicare Part D prescription drug plans compare with their specific formularies have not been released as of Monday, September 11, 2017.

The 2018 Medicare Part D costs and copays are explained below.

Part D changes for 2018 are:

  • Initial Deductible:
    will be increased by $5 from $400 in 2017 to $405 in 2018.
  • Initial Coverage Limit:
    will increase by $50 from $3,700 in 2017 to $3,750 in 2018 where the 2018 “Donut Hole”
  • Out-of-Pocket Cost: will increase also increase by $50 from $4,950 in 2017 out of pocket to $5,000 in 2018 out of pocket: begins once you reach your Medicare Part D plan’s initial coverage limit ($3,750 in 2018) and ends when you spend a total of $5,000 in 2018. You will spend 35% of covered brand name drugs, the drug manufacturer will pay 50% and the prescription drug plan will pay the remaining 15% of the covered brand name prescription. For generics in the donut hole, you will pay maximum 44% co pay and the prescription drug plan will pay the remaining 56%.
  • If your prescriptions are not in your Part D formulary, then YOU WILL pay 100% of the prescription drug cost, which is why one must verify that all their prescriptions are in the specific chosen Medicare Part D formulary which can change every year.

Toni’s Tips to help you stay out of the Donut Hole or not get in it as soon:

  • Use medicare.gov when selecting a Medicare Part D plan whether it is your first time or changing during Medicare’s Annual Enrollment Period in the fall.
  • Talk to your doctor or doctors about which brand name drugs can be changed to generics.
  • Use your Medicare Part D plan for your brand name drugs and expensive generics. You do not have to put every prescription on your Medicare Part D plan.

 

Toni King, author of the new Medicare Survival Guide® and its new companion “Confused about Medicare” workshop DVD that are now on sale at www.tonisays.com.  Medicare consultations are available at the Toni Says office or email questions to info@tonisays.com or call 1/844-250-8664.

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