Each year on January 1st, your Prescription Plan starts totalling the retail cost of your prescriptions. When you look at your monthly statement from your Part-D plan you will see a list of the prescriptions you purchased during the previous month. The list will include a table listing the name of each prescription along with the retail cost, the amount paid by the insurance company, and the amount paid by you. The statement will also include year-to-date totals for each of these amounts. The numbers you are interested in are the Monthly and Year-To-Date totals for "Retail" cost. When the year-to-date Retail Cost reaches $2,410 you enter the "donut hole" and you must begin paying the entire cost of your prescription drugs.
You can entimate if and when you will enter the donut hole by looking at your monthly retail costs. If this amount is below $200, and your prescription usage remains the same for the remainder of the year, then you will not enter the donut hole. If your monthly retail costs are over $200 then divide $2,410 by your monthy total. The result will be the number of the month in which you will enter the donut hole or "gap." |