Doug Benson

What is Medicare Assignment?

by Doug Benson November 20, 2010

Assignment is an agreement between you, Medicare, and your doctor or other healthcare provider. You “assign” Medicare to pay your doctor or healthcare provider directly for their services. Most doctors, and healthcare providers accept assignment. If they do not accept assignment, they are allowed to charge you more than the Medicare Approved amount. But they […]

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Medicare Generic Prescriptions

by Doug Benson November 10, 2010

According to the FDA, A generic drug is a copy of a brand name drug in dosage, safety, strength, how it is taken, quality, performance and intended use. The FDA requires that all drugs be safe and effective. Since generics use the same active ingredients and are shown to work the same way in the […]

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What is the Donut Hole, Gap, Coverage Gap

by Doug Benson November 10, 2010

Also Known As The Gap, Coverage Gap, and several four-letter words 🙂 Donut Hole, Coverage Gap, The Gap – Most Part-D plans have a coverage gap, which is usually referred to as the “donut hole.” This is a confusing aspect to the Part-D plans that many people have never had explained properly. How does the […]

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Brand Name Prescriptions

by Doug Benson November 10, 2010

With regard to Medicare Part D Plans, brand named prescriptions are usually covered under Tier 2 or 3 of Medicare Part D plans. The retail costs of brand named prescriptions is higher than those of generic prescriptions, so the associated co-pays for brand named prescriptions are higher. Brand-name drugs generally have patent protection for 20 […]

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Medicare Part-D Deductible

by Doug Benson October 10, 2010

Medicare has included a deductible as part of it’s “standard” part-d plan definition. The amount of the deductible generally changes each year. You must pay 100% of your prescription costs until you satisfy the part-d deductible. Some part-d plans cover part or all of the standard deductible for you.

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Medicare Part-D Formulary

by Doug Benson October 10, 2010

This is the list of drugs that must be covered by all Part-D plans. This list is called the “Standard” formulary. Generally, each year the standard formula is modified. New drugs are added, sometimes some are removed. All companies who offer Medicare Part-D plans must include every drug in the standard formulary. Plans can offer […]

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Medicare Part-D Initial Coverage Limit

by Doug Benson October 10, 2010

After you pay the Medicare Part-D deductible, you enter the Medicare Part-D Initial Coverage Period. While you are in the initial coverage period you will pay approximately 25 percent of your drug costs and the Part D plan pays approximately 75 percent. The next threshold is the Initial Coverage Limit. Like the deductible, this number […]

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