Coverage Gap/Doughnut Hole
Medicare has adjusted drug coverage for 2018. You will now get $3,750 of coverage before reaching the Coverage Gap or Doughnut Hole. In the initial stage you pay a co-pay or coinsurance and your plan pays the rest. You stay in this stage until the total costs for your drugs reach $3,750. The Coverage Gap/Doughnut Hole is set by Medicare and is the same with every plan.
You may qualify for "Extra Help with Prescription Drugs" with certain incomes and assets. Please see this government publication on how to qualify & apply.
Another resource is to check the site Prescription Hope as a source for brand drugs.
Medicare Annual Enrollment Period
Call us Toll Free 877-846-5643
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We can help you choose a plan that suits your individual needs using a Medicare Advantage plan (HMO or PPO), or a Medicare supplement that allows you to use any doctor & hospital.
Call usToll Free 877-846-5643
People with Medicare Advantage plans can enroll in a different plan for January beginning October 15 through December 7. Preview of plans begins October 1. As independent agents we can help you select a plan, choosing the one with benefits well suited for you. Most of our area plans are HMO's or PPO's. HMO's require referrals to specialists from a primary care doctor, and you must stay in the plan's network. For these restrictions, co-pays are typically lower than PPO's. PPO's require no referrals from a primary doctor. You may stay in the network to save money or go out of network and pay more. PPO's still require plan authorization for tests, procedures, surgeries, etc.
Plans will mail an Annual Notice of Change by October 1. If you are satisfied with the 2018 changes your enrollment will automatically continue with no action needed.
You may also change your Prescription Drug Plan during this time. Remember the Doughnut Hole is set by Medicare and is the same on all plans. This will be phased out by 2020.
People with Medicare Supplements do not need to take any action during this time. These plans continue as long as premiums are current. Supplements allow you to use any doctor with no referrals or authorizations. You also need to keep your Medicare premiums current and add a separate drug plan.
Follow this link for more helpful Medicare information
Medicare does not cover dental, although some HMO's and PPO's may cover some services. For more information on dental coverage check this site: