UNITED STATES—Toni: This year, the 2022 Medicare and You handbook did not include all the information regarding the Medicare Part D deductibles and “Donut Hole.” I got in the “famous” Medicare donut hole this August and do not know how I got there.
I know it is October, but I would like to get prepared and really cannot find the answer online or at the Medicare.gov website. Please inform me what are the 2022 Medicare Part D costs. I look forward what you have to say. Cathy from St. Louis.
Cathy: You are correct that the 2022 Medicare and You handbook did leave information out regarding the 2022 Medicare Part D deductibles or out of pocket maximums.
But guess what?? For the Toni Says® Medicare newspaper column readers, we have a surprise! I know what the Medicare Part D cost, copays, and Donut Hole out of pocket will be beginning January 1, 2022.
2022 Medicare Part D costs and co-pays are explained below:
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 $4430 in 2022 where the 2022 “Donut Hole” begins.
-Out-of-Pocket threshold cost: or (TrOOP true out of pocket) 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 percent Donut Hole discount on the total cost of their brand-name drugs purchased while in the Donut Hole. The discount includes, a 70 percent discount paid by the brand-name drug manufacturer and a 5 percent discount paid by your Medicare Part D plan. The 70 percent paid by the drug manufacturer, 5 percent Part D plan discount combined with the 25 percent you pay, count toward your TrOOP or Donut Hole exit point.
-Generic and Brand Name Drug Donut Hole Co-Pay: when one reaches Medicare Part D Donut Hole: pay a maximum of 25 percent co-pay on generic or brand name drugs purchased while in the Coverage Gap.
-Lower costs when one comes out of the Donut Hole and enters Catastrophic coverage which is $3.95 for generics under $79 and $9.85 brand name drugs under $197 or over these for generic and brand name drugs there is only a 5 percent cost for the prescription drugs until December 31 and a new year begins. Then the Medicare Part D cycle begins again with a new deductible and co-pays on January 1 of every year.
Toni Says® Tips:
1) During Medicare’s Annual Enrollment Period from October 15 to December 7 be sure that all prescriptions are covered by a new standalone Medicare Part D plan or a Medicare Advantage plan with prescriptions which will begin January 1.
2) Remember you will pay 100 percent of the cost if any prescriptions (generic or brand name) are not covered on your Medicare Part D plan.
3) Talk to your doctor or doctors about which brand name drugs can be changed to generics.
4) Get samples from your doctor.
5) Call Toni Says Medicare Office at 832-519-8664 for Medicare Part D 2022 Prescription Drug planning.
Do not forget…There is a penalty for not enrolling in a Medicare Part D Prescription Drug plan when you first become eligible to enroll.
Toni King, Medicare author/advocate is giving a $10 discount to the Toni Says® readers on the 2021Medicare Survival Guide® Advanced book at www.tonisays.com or call 832-519-8664.