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May 27, 2013

What is the Texas Medicare Donut Hole?

The Medicare Donut Hole is a gap in Texas Medicare Part D drug coverage. Pharmaceutical costs and an increased use of expensive specialty drugs are some major reasons for the Medicare Donut Hole. More Medicare recipients reach the Medicare Donut Hole each year, costing beneficiaries a great deal of money. When you reach the Medicare Donut Hole you are responsible for all of your drug costs until you reach what is known as the catastrophic coverage limit.

Will I fall into the Texas Medicare Donut Hole?

The Medicare Donut Hole affects individuals who spend over a certain amount on drugs during the initial coverage phase of each year. In 2011, Medicare Part D beneficiaries pay 25% of their drug costs after paying the initial deductible until their total expenses hit $2,840. Once they hit that amount, they will have reached the Medicare Donut Hole. In the Medicare Donut Hole, beneficiaries are responsible for all their drug costs until annual total drug costs hit $6,400, also known as the catastrophic coverage limit. It is only after reaching that amount that Medicare would cover 95% of drug costs for the rest of the year.

Although some plans offer additional Medicare drug coverage to guard against the Medicare Donut Hole, these plans often have higher copays and premiums. This is why it's important to consider the amount you spend on prescription drugs before selecting a Part D plan to help protect against the Medicare Donut Hole. Careful planning can help you avoid the Medicare Donut Hole.

How can I avoid the Texas Medicare Donut Hole?

When trying to protect yourself from the Medicare Donut Hole you have 3 options. Your first option is to purchase additional coverage to protect yourself from the Medicare Donut Hole. If you are interested in purchasing additional coverage for protection from the Medicare Donut Hole, you can visit PlanPrescriber.com to compare Medicare Part D plans in your area. Most plans that offer coverage to guard against the Medicare Donut Hole charge a higher premium. However, if you are in danger of falling into the Medicare Donut Hole it may save you money in the long run. You can also avoid the Medicare Donut Hole by using cheaper generic drugs whenever possible. Talk to your doctor or pharmacist about generic drugs to ensure that you are receiving the least expensive prescription whenever possible to avoid the Medicare Donut Hole. There are also many government programs available to assist those who may fall into the Medicare Donut Hole. You can locate several programs offered by non profits and community organizations to help protect against the Donut Hole by using the Benefits Checkup website, checking with your local council on aging and by visiting the Social Security Administration.

What is the government doing to fix the Texas Medicare Donut Hole?

In response to the growing problems caused by the Medicare Donut Hole the government has enacted a new program. Anyone who reaches the Medicare Donut Hole in 2011 will receive a 7% discount on all generic prescription drugs and a 50% discount on all name brand pharmaceuticals to help with the Medicare Donut Hole. The goal of the program is to continue providing savings each year in an attempt to eliminate the Medicare Donut Hole by 2020. If you are having difficulty paying for your prescription drugs, take the time to find out about programs that can help you avoid falling victim to the Medicare Donut Hole.

Medicare has neither approved nor endorsed this information.