Dear Angel,
This year, the 2022 Medicare and You handbook didn’t include all the information regarding the Medicare Part D deductibles and the “Donut Hole.” What am I missing? Thanks for your help!
Missy Ing-Infoe
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Dear Missy,
You are correct that the 2022 Medicare and You handbook did leave information out regarding the 2022 Medicare Donut Hole, including Part D deductibles or out of pocket maximums. Luckily, I can provide information on what the Medicare Part D cost, copays, and Donut Hole out of pocket will be beginning January 1, 2022.
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 $4,430 in 2022, which is where the 2022 “Donut Hole” begins.
– Out-of-Pocket threshold cost 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 and 5% Part D plan discount combined with the 25% you pay both count toward your Donut Hole exit point.
Remember you will pay 100% of the cost if any prescriptions (generic or brand name) not
covered under your Medicare Part D plan.
Also, don’t forget . . . there is a penalty for not enrolling in a Medicare Part D Prescription Drug plan when you first become eligible to enroll, so be sure to do so.
Hope this helps,
Angel