Q1Medicare.com Brings the Finalized 2013 Medicare Part D Defined Standard Benefit Parameters Online

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The finalized 2013 Medicare Part D prescription drug plan Defined Standard Benefit parameters are now online at Q1Medicare.com/2013, along with a chart illustrating how these plan values have changed since 2006. The Medicare Part D defined standard benefit parameters are released each year and provide Medicare beneficiaries with a preview of the upcoming 2013 Medicare Part D prescription drug plan designs. Based on the recently released information, Medicare beneficiaries will find that all of the 2013 model plan values, such as the standard initial deductible, initial plan coverage limits, and the Donut Hole boundaries will increase slightly over the current 2012 values. To help the Medicare community visualize how these 2013 changes can affect next year’s prescription drug spending, Q1Medicare.com has also launched their 2013 PDP-Planner or Donut Hole Calculator.

[We] find the defined standard benefit values to be a good indicator of what to expect this October when all of the 2013 Medicare Part D plan details are officially released.

Q1Medicare.com now has the final 2013 Medicare Part D Prescription Drug Plan Defined Standard Benefit parameters online, along with a chart illustrating how these plan values have changed each year since 2006. The 2013 values and accompanying chart can be found at Q1Medicare.com/2013.

The Defined Standard Benefit parameters are released each year by the Centers for Medicare and Medicaid Services (CMS) and set minimum limits for standard Medicare Part D prescription drug plan coverage. Medicare Part D plan providers are permitted to deviate from the CMS defined standard benefits when they design their plans and, with Medicare approval, can offer Medicare Part D prescription drug plans with more enhanced features.

“Most stand-alone Medicare Part D prescription drug plans offer a variation to the CMS Standard Defined Benefit,” notes Dr. Susan Johnson, Technical Director of the Q1Medicare.com website. “However, we still find the defined standard benefit values to be a good indicator of what to expect this October when all of the 2013 Medicare Part D plan details are officially released.”

As can be seen on the Q1Medicare.com/2013 page, the final 2013 defined standard benefit plan parameters show a slight increase above the same 2012 values. For example, Medicare beneficiaries enrolling in a 2013 Medicare Part D prescription drug plan modeled after the CMS Defined Standard Benefit will find the 2013 initial deductible increasing from the current value of $320 to $325. Likewise, the initial coverage limit will increase to $2,970 from the current 2012 limit of $2,930, meaning that Medicare beneficiaries with an average monthly negotiated retail drug cost of over $248 can expect to enter the Donut Hole sometime in 2013.

The exit point to the Donut Hole, or out-of-pocket threshold, will also increase slightly from the current 2012 value of $4,700 to $4,750 in 2013. Therefore, anyone who reaches the 2013 Donut Hole will need to spend slightly more money before entering the catastrophic coverage portion of their 2013 Medicare Part D plan, at which time their prescription drug cost-sharing will be significantly reduced.

On the positive side, 2013 will also bring an increase in the Donut Hole Discount whereby Medicare beneficiaries who purchase their prescriptions in the coverage gap will receive a 21% discount on generic medications and a 52.5% discount on brand-name drugs.

To help seniors visualize how the 2013 changes might impact their spending, Q1Medicare.com has launched their 2013 PDP-Planner tool (or Donut Hole Calculator) utilizing the 2013 CMS Defined Standard Benefit Part D prescription drug plan parameters. The 2013 PDP-Planner allows users to enter their estimated retail prescription costs based on current spending and their initial deductible to preview what they can expect to pay throughout the different phases of their 2013 Medicare Part D plan coverage. The 2013 PDP-Planner can be found at: PDP-Planner.com/2013.

Like all Q1Medicare.com tools, the 2013 PDP-Planner is available at no cost and is designed to be accessible on PC, smartphone, or tablet platforms. PDP-Planner users also have the option to receive a copy of their 2013 spending estimates via eMail.

About the Q1Medicare.com Website
Q1Medicare.com is one of the largest independent online resources for Medicare Part D prescription drug plan and Medicare Advantage 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, advisers, and agents better understand the Medicare Part D and Medicare Advantage programs. 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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