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Part D 2013 Standard Benefit Model Changes

Part D 2013 standard benefit model changes mean greater out-of pocket costsGraph Show Price Increase Under Magnifying Glass

In today’s economy counting pennies has become  important for some people to meet their monthly budgets. With health care costs rising and Social Security cost of living raises non-existent you need to have an affordable Part D drug plan.

The following information details the Part D 2013 standard benefit model changes. Although the changes are not too drastic for 2013, looking at historical data demonstrates that your Part D benefit may become more expensive in coming years.

The details below highlight the Part D standard benefit plan which represents  the minimum allowable plan benefits that can be off

Part D standard benefit model

Initial Part D deductible – can be as high as $325 which is up from $320 for 2012 plans.

Initial coverage limit – will be set at $2970 up from $2930 for 2012 plans.

Out-of-pocket threshold amount – increases to $4750 from $4700 in 2012.

Donut hole – The coverage gap begins when the initial coverage limit of $2970 has been met and ends when the out-of-pocket threshold of $4750 has been met.

The Catastrophic coverage portion – for 2013 is reached after you have come out of the donut hole. Minimum cost sharing will increase to the greater of 5% or $2.65 for generic or preferred drugs that are a multi-source drugs and the greater of 5% or $6.60 for all other drugs.

Help within the Part D donut hole

Thanks to health care reform you will still receive help when you are in the coverage gap. You will pay only 47.5% for brand name drugs and a maximum of 79% for generic drugs.

The full price of the drugs will still count toward getting out of the donut hole even though you are only paying a portion of the full cost. It would be very surprising to see any type of donut hole rebate given the brewing budget battles in Washington D.C.

Do You Qualify for extra help with Part D Costs?

 Insurance companies may begin marketing  Part D plans as early as October 1 and plans with a January effective date may be applied for between October 15th, and December 7th.

Compare plans online or visit the Medicare website to see all available plans in your area.


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