Part D Donut Hole Coverage

Recently we had a client who had an Aetna Part D plan through our organization. It was May and Aetna only had received January’s premium, so they sent our client a letter stating that his Part D Drug Plan was going to be cancelling. Ended up he was sending his premium to the wrong company and none of his checks were being cashed.

Well come June his Part D Plan had been cancelled and he called us in a frenzy asking how his 7 prescription drugs were going to be covered. We were a little uncertain at the time but after checking with Aetna to see if it could be reinstated and finding out that it couldn’t we looked into a plan that we had that is based on the 800 series chasse of Medicare Part D Plans. These plans can be enrolled in anytime throughout the year with a 1st of the month effective date and they are “Creditable Coverage” plans.

Our client read us his list of prescription drugs and we looked them up through this plan to see if they were covered. Ended up all his drugs were covered and his two pain patches for his back would be covered as Generic coverage. These drugs were $300 a piece by themselves not including his other drugs. So these $600 a month pain patches were now only going to cost $10 even through the donut hole (coverage gap) because this plan had complete donut hole coverage. Now the premium for this plan was expensive ($300) but it was a much better option than going at it alone. Most of the time this plan will be a great option for the individual if they are reaching the coverage gap by the month of June.

For Part D coverage explanation you can talk to one of our senior market advisors, but for enrollment advice and plan consultation you must have other insurance with our organization (Medigap Plan, Medicare Advantage, Life Insurance, and Annuity).

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