Chances are, if you have been reading anything about Medicare or you actually already have Medicare benefits, then you have heard of the donut hole. This donut hole, which is actually a gap in coverage, has long been considered the most frustrating thing about Medicare benefits. This only applies to Medicare Part D, which is the prescription plan in 2013 that is offered through the services. However, it is absolutely vital that you understand what it is so that you will not find yourself left with big expenses when you need to get prescription drugs. Here is what you need to know.
The donut hole is a gap in services that comes along after the patient has used a certain amount of their Medicare benefits. During this gap in coverage, patients will be responsible for 100% of their prescription drug costs. That can amount to a great deal of money in a short amount of time. Here is when the gap will come along.
When you have Part D for 2013 as your primary coverage, you will be responsible for paying something called a co-payment most of the time. This co-payment will amount to a very small amount of the prescription cost and it works much like any insurance would. However, when Medicare has paid out a total of $2,840 in prescriptions for you in a given year, then you will have reached the donut hole. During this time, you will have to pay full price. The coverage will not come back into effect until you have spent $4,500 out of pocket for your prescriptions. That is a great deal of money that you will be responsible for.
Is there any way to avoid paying so much money and dealing with the Medicare donut hole? The good news is that there is. To start with, Medicare reform laws that we explain here are being worked on currently in order to make this expense less of a blow in 2012/2013. In addition, you could choose to get supplemental insurance. Generally, supplemental insurance will not cost that much and it will continue providing coverage throughout the dreaded Medicare donut hole.
The 2013 Donut hole is something that you absolutely need to understand if you have Medicare Part D coverage. If you do not know that a gap in coverage is coming, then you could find yourself facing hundreds of dollars in expense when you just do not have the money in your budget. However, there are ways to make the donut hole less frustrating and detrimental to you.