Click here to see a comparison of plan parameters for all years since 2006
Medicare Part D Benefit Parameters for Defined Standard Benefit 2006 through 2008 Comparison |
|||
Part D Standard Benefit Design Parameters: | 2008 | 2007 | 2006 |
Deductible - (after the Deductible is met, Beneficiary pays 25% of covered costs up to total prescription costs meeting the Initial Coverage Limit. | $275 | $265 | $250 |
Initial Coverage Limit - Coverage Gap (Donut Hole) begins at this point. (The Beneficiary pays 100% of their prescription costs up to the Out-of-Pocket Threshold) | $2,510 | $2,400 | $2,250 |
Total Covered Part D Drug Out-of-Pocket Spending including the Coverage Gap - Catastrophic Coverage start after this point. | $5,726.25 | $5,451.25 | $5,100.00 |
Out-of-Pocket Threshold - This is the Total Out-of-Pocket Costs including the Donut Hole. 2008 Example: $275 (Deductible) + (($2,510 - $275) * 25%) (Initial Coverage) + (($5,726.25-$2,510) * 100%) (Donut Hole) = $4,050 (Maximum Out-Of-Pocket Cost prior to Catastrophic Coverage - excluding plan premium) |
$4,050 $ 275.00 $ 558.75 $3216.25 $4050.00 |
$3,850 $ 265.00 $ 533.75 $3051.25 $3850.00 |
$3,600 $ 250.00 $ 500.00 $2850.00 $3600.00 |
Catastrophic Coverage Benefit: | |||
Generic/Preferred Multi-Source Drug | $2.25 | $2.15 | $2.00 |
Other Drugs | $5.60 | $5.35 | $5.00 |
Part D Full Benefit Dual Eligible Parameters: | 2008 | 2007 | 2006 |
Copayments for Institutionalized Beneficiaries | $0.00 | $0.00 | $0.00 |
Maximum Copayments for Non-Institutionalized Beneficiaries | |||
Up to or at 100% FPL: | |||
Up to Out-of-Pocket Threshold | |||
Generic/Preferred Multi-Source Drug | $1.05 | $1.00 | $1.00 |
Other | $3.10 | $3.10 | $3.00 |
Above Out-of-Pocket Threshold | $0.00 | $0.00 | $0.00 |
Over 100% FPL: | |||
Up to Out-of-Pocket Threshold | |||
Generic/Preferred Multi-Source Drug | $2.25 | $2.15 | $2.00 |
Other | $5.60 | $5.35 | $5.00 |
Above Out-of-Pocket Threshold | $0.00 | $0.00 | $0.00 |
Part D Non-Full Benefit Dual Eligible Full Subsidy Parameters: | 2008 | 2007 | 2006 |
Resources < $6,120 (individuals) or < $9,190 (couples) | |||
Maximum Copayments up to Out-of-Pocket Threshold | |||
Generic/Preferred Multi-Source Drug | $2.25 | $2.15 | $2.00 |
Other | $5.60 | $5.35 | $5.00 |
Maximum Copay above Out-of-Pocket Threshold | $0.00 | $0.00 | $0.00 |
Resources between $6,120-$20,210 (individuals) or $9,190-$20,410 (couples) | |||
Deductible | $56.00 | $53.00 | $50.00 |
Coinsurance up to Out-of-Pocket Threshold | 15% | 15% | 15% |
Maximum Copayments above Out-of-Pocket Threshold | |||
Generic/Preferred Multi-Source Drug | $2.25 | $2.15 | $2.00 |
Other | $5.60 | $5.35 | $5.00 |
Part D Non-Full Benefit Dual Eligible Partial Subsidy Parameters: | 2008 | 2007 | 2006 |
Deductible | $56.00 | $53.00 | $50.00 |
Coinsurance up to Out-of-Pocket Threshold | 15% | 15% | 15% |
Maximum Copayments above Out-of-Pocket Threshold | |||
Generic/Preferred Multi-Source Drug | $2.25 | $2.15 | $2.00 |
Other | $5.60 | $5.35 | $5.00 |