Page 46 - July 2024 Issue

of your plan’s prescription costs is a percentage of the drug costs.
Senior until your out of pocket reaches at percentage is capped at 25%.

the deductible. Generally, the full
For 2024 your out-of-pocket
Spot costs are smaller than the gross would be $1,257.50. Note that your
costs of your drugs. Tiering, or the
premium does NOT count toward
designated levels assigned by the

plans, a ects your costs, and can your out-of-pocket contribution.

Senior Moments change from plan to plan. is phase ends when the
combined payments for drugs
by Mary Moran If your medications are designated between you and the plan reaches
410-479-2535 or 410-490-3078 as tier 1 and tier 2 on the plan $5,030. e gong goes o when

formularies, they do not kick in that number is reached, and you
Happy Summer, folks! June’s rains the deductible. Tier 1 and 2 drugs enter the Coverage Gap!
certainly jumped up the corn this are most likely generic meds,
year, and the Shore is looking and depending on the plan, can Phase 3 is the Coverage Gap, aka
beautiful! So, let’s appreciate the cost very little or nothing at all. the Donut Hole. Your cost in
beauty around us and try not to get Remember when shopping for a the donut hole goes up but the
frustrated with the construction Medicare D plan that only tier 3 manufacturer of the drugs steps in
on route 16 or the “reach the and up activates the deductible. and provides a 70% discount on

beachers” on Route 404! We are Most plans have tiers up to tier 5 the retail cost. e plan is limited

adaptable people and know how to for specialty or compound drugs, in what it pays for the drugs. e
count our blessings, so let’s enjoy a however some plans go as high as plan does pay 75% for generic
frosty beverage and eat some crabs! tier 6. drugs, with 25% of the cost paid

Pass the Old Bay, please! by the bene ciary. e plan only
Phase 2 is the Initial Coverage pays 5% of the cost of brand-name

is time of year, SHIP gets more stage and is about cost sharing. drugs, with 25% being passed onto
frequent calls about changes in is is where the plan starts paying you. You exit the coverage gap

Medicare part” D” drug costs. is a portion of the costs of your meds when your total out of pocket costs
is due to people passing through if the drug is on their formulary. (not including premiums) reaches
the phases of the program. So, e plan will pay up to $3,772.50 $8,000. is is calculated by adding

for those taking that journey, and for the year. You pay the other together the yearly deductible,
those who are new to Medicare, a portion, either as a copay which your coinsurance and copays, and
review is in order. is a set dollar amount that should what you paid in the coverage gap
Phase 1 is about reaching your be listed on the Medicare .gov for drugs, plus the discounted
deductible. You pay the full cost printouts, or a coinsurance which amounts you did not pay that were
picked up by the manufacturer.
Phase 4 Catastrophic coverage
A comfortable and begins when your total out-of-
pocket costs reach $8,000. During
secure home for this payment phase, there is a cap
on Generic drugs of $4.50 and
living a full and a cap on Brand-name drugs of

meaningful life! $11.20. Generally, the plan pays
the full cost of your covered part
D drugs in the Catastrophic phase.
ASSISTED LIVING AND SENIOR CARE You remain in this phase until the
end of the year.

e prices re ected in Phase 4

www.arcadia-living.com are the prices paid by those who
qualify for Extra Help. In

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