HealthBridge's In-Home Care Blog

Our friends at AARP have created a forward thinking new tool to help people calculate if and when they’ll find themselves in the dreaded Medicare Part-D Doughnut Hole.  In case you’ve been hibernating for the past couple of years or have the good fortune not to take too many prescription drugs, we’ll explain the Doughnut Hole.

After a $295 deductible is met, Medicare’s prescription drug coverage picks up the tab for 75% of drug costs up to $2,700.  While your costs are $2,700 - $6,154, Medicare does not cover any part of the drug cost.  After $6,154, Medicare pays 95% of the tab.  The $4,350.25 that Medicare beneficiaries pay out of pocket in the middle is considered the doughnut hole.

Despite Medicare’s overwhelming popularity among beneficiaries, the doughnut hole is consistently the subject of ire and discontent.  No wonder.  Remember, the $4,350.25 isn't spread out over a year.  It hits like a ton of bricks until you're through it.

I think you'll find the AARP tool helpful for a few reasons:

1. You select the actual Part D plan you have, so your results are much more accurate.
2. You select specific drugs and dosages, again, for more accurate results.
3. Once you've selected your plan and your prescriptions, the tool displays a graph to show you exactly when you'll be in the doughnut hole.

But, as our senior care clients tell me, simply knowing you're in a black hole (er, excuse me, doughnut hole) isn't very helpful.  You'll like the tool because you can: