Changes to 2022 Medicare Part D Co-Pays and Donut…Released!
Toni:
This year, the 2022 Medicare and You handbook did not include all the information regarding the Medicare Part D deductibles and “Donut Hole”. I got in the “famous” Medicare donut hole this August and do not know how I got there.
I know it is October, but I would like to get prepared and really cannot find the answer online or at the Medicare.gov website. Please inform me what are the 2022 Medicare Part D costs.
I look forward what you have to say. Cathy from St. Louis
Cathy:
You are correct that the 2022 Medicare and You handbook did leave information out regarding the 2022 Medicare Part D deductibles or out of pocket maximums.
But guess what?? For the Toni Says® Medicare newspaper column readers, we have a surprise! I know what the Medicare Part D cost, copays, and Donut Hole out of pocket will be beginning January 1,2022.
2022 Medicare Part D costs and co-pays are explained below:
Part D changes for 2021 are:
- Initial Deductible: will increase by $35 from $445 in 2021 to $480 in 2022.
- Initial Coverage Limit:will increase by $300 from $4,130 in 2021 to $4430 in 2022 where the 2022 “Donut Hole”
- Out-of-Pocket threshold cost: or (TrOOP true out of pocket) will increase from $6,550 in 2021 to $7,050 in 2022.
- Coverage Gap (Donut Hole): begins once you reach your Medicare Part D plan’s initial coverage limit $4,430 in 2022 and ends when you spend a total of $7,050 out-of-pocket in 2022.
- What is the Donut Hole Discount?: Part D enrollees will receive a 75% Donut Hole discount on the total cost of their brand-name drugs purchased while in the Donut Hole. The discount includes, a 70% discount paid by the brand-name drug manufacturer and a 5% discount paid by your Medicare Part D plan. The 70% paid by the drug manufacturer, 5% Part D plan discount combined with the 25% you pay, count toward your TrOOP or Donut Hole exit point.
- Generic and Brand Name Drug Donut Hole Co-Pay: when one reaches Medicare Part D Donut Hole: pay a maximum of 25% co-pay on generic or brand name drugs purchased while in the Coverage Gap.
- Lower costs when one comes out of the Donut Hole and enters Catastrophic coverage which is $3.95 for generics under $79 and $9.85 brand name drugs under $197 or over these for generic and brand name drugs there is only a 5% cost for the prescription drugs until December 31and a new year begins. Then the Medicare Part D cycle begins again with a new deductible and co-pays on January 1 of every year.
Toni Says® Tips:
- During Medicare’s Annual Enrollment Period from October 15th to December 7th be sure that all prescriptions are covered by a new standalone Medicare Part D plan or a Medicare Advantage plan with prescriptions which will begin January 1st.
- Remember you will pay 100% of the cost if any prescriptions (generic or brand name) are not covered on your Medicare Part D plan.
- Talk to your doctor or doctors about which brand-name drugs can be changed to generics.
- Get samples from your doctor.
- Call Toni Says Medicare Office at 832/519-8664 for Medicare Part D 2022 Prescription Drug planning.
Do not forget…There is a penalty for not enrolling in a Medicare Part D Prescription Drug plan when you first become eligible to enroll.
- 2021 Confused about Medicare Annual Enrollment Zoom online webinar is Wednesday, November 17th at 4:00 PM. Visit tonisays.com to sign up for Toni’s new Zoom online webinar event.
Toni King, Medicare author/advocate is giving a $10 discount to the Toni Says® readers on the 2021Medicare Survival Guide® Advanced book at www.tonisays.com or call 832/519-8664.
