Q1Medicare.com Brings the 2012 Medicare Part D Defined Standard Benefit Parameter Changes Online

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The 2012 Medicare Part D prescription drug plan Defined Standard Benefit parameters are now online at Q1Medicare.com/2012 and illustrate the changes in basic or standard Medicare Part D plan coverage since 2006. The Defined Standard Benefit parameters also give a preview to the basic design of the 2012 Medicare Part D prescription drug plans. Next year, all of the 2012 model plan parameters, such as the standard Initial Deductible, Initial Coverage Limit, and Donut Hole boundaries will increase slightly over the 2011 values. Q1Medicare.com has also updated the 2012 PDP-Planner or Donut Hole Calculator to help the Medicare community visualize how these 2012 changes can affect next year’s prescription drug spending.

Q1Medicare.com now has the 2012 Medicare Part D Prescription Drug Plan Defined Standard Benefit parameters online along with a chart comparing how these parameters have changed each year since 2006. The chart can be found at Q1Medicare.com/2012. The Defined Standard Benefit parameters are released each year by the Centers for Medicare and Medicaid Services (CMS) and set basic limits for standard Medicare Part D prescription drug plan coverage.

“Medicare Part D plan providers are permitted to deviate from the CMS Defined Standard plan and offer Medicare Part D prescription drug plans with more enhanced features,” notes Dr. Susan Johnson, Technical Director of the Q1Medicare.com website. “However, we still find the Defined Standard Benefit to be a good basic indicator of what to expect in October when all of the 2012 Medicare plan details are officially released.”

As can be seen on the Q1Medicare.com/2012 page, the 2012 parameters show a slight increase above the 2011 values. For example, Medicare beneficiaries enrolling in a 2012 Medicare Part D prescription drug plan modeled after the CMS Defined Standard Benefit will find their 2012 Initial Deductible increasing from $310 to $320. The standard Initial Coverage Limit will also increase to $2,930 from the current 2011 limit of $2,840, meaning that a Medicare beneficiary with average monthly negotiated retail drug costs over $244 can expect to enter the 2012 Donut Hole.

The 2012 Donut Hole exit point or Out-of-Pocket threshold will increase slightly from the current 2011 value of $4,550 to $4,700 in 2012. Therefore, a person in the Donut Hole will need to spend slightly more money in 2012 before entering the Catastrophic Coverage portion of their Medicare Part D plan. On the positive side, 2012 will also bring an increase in the Donut Hole Discount whereby Medicare beneficiaries will receive a 14% discount on generic medications, an increase over the current 2011 7% generic drug discount and continue to receive a 50% discount on brand name drugs.

Q1Medicare.com also released the updated 2012 PDP-Planner tool (or Donut Hole Calculator) utilizing the 2012 CMS Defined Standard Medicare Part D prescription drug plan benefit parameters. The 2012 PDP-Planner allows users to enter their estimated retail prescription costs, Initial Deductible and monthly Part D plan premiums to preview their 2012 Medicare Part D expenses throughout the different phases of their Medicare Part D plan coverage. The 2012 PDP-Planner can be found at: PDP-Planner.com/2012.

“Although seniors and other Medicare beneficiaries can prepare now for the increases in their 2012 Part D plan costs, we also want to remind them about the changes to their next Annual Enrollment Period that starts in October this year,” adds Dr. Johnson.

The 2012 Annual Enrollment Period is when seniors and other Medicare beneficiaries can add, change or drop their Medicare Part D prescription drug plan coverage and this year, it will start on October 15th and continue through December 7th with 2012 drug coverage beginning on January 1st, 2012. In past years, the Annual Enrollment Period started on November 15th and continued through December 31st.

About the Website Q1Medicare.com
Q1Medicare.com is one of the largest independent online resources for Medicare Part D prescription drug plan information. Q1Medicare.com offers a large section of Frequently Asked Questions, online tools, and a free Medicare Part D Newsletter all designed to help Medicare beneficiaries, caregivers, advocates, advisors, and insurance agents navigate the Medicare prescription drug program. Q1Medicare.com is operated by Q1Group LLC (Saint Augustine, Florida).


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Lynnea Christner

Susan Johnson MS-MIS, MBA, PhD
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