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What is the Outlook for Medicare Part D 2010?

CMS Part D 2010 Standard Benefit Model Plan Details

Here are the highlights for the CMS defined Standard Benefit Plans for 2006, 2007, 2008, 2009 and 2010. This "Standard Benefit Plan" is the minimum allowable plan to be offered. The details of the 2010 plan will not be released until mid-April 2009. As we learn details, they will be added to the highlights and chart below.

Initial Deductible:

from $295 in 2009 to $310* in 2010

Initial Coverage Limit:

from $2,700 in 2009 to $2,830* in 2010

Out-of-Pocket Threshold: from $4,350 in 2009 to $4,550* in 2010

Minimum Cost-sharing in the Catastrophic Coverage Portion of the Benefit:
from $2.40 for generics and $6.00 for other drugs in 2009 to $2.50 for generic or preferred drug that is a multi-source drug and $6.30* for all other drugs in 2010

Maximum Co-payments below the Out-of-Pocket Threshold for certain Low Income Full Subsidy Eligible Enrollees:

from $2.40 for generics and $6.00 for other drugs in 2009 to $2.50 for generic or preferred drug that is a multi-source drug and $6.30* for all other drugs in 2010

Look below for Medicare D Benifit Parameters

Medicare Part D Benefit Parameters for Defined Standard Benefit 2006 through 2010 Comparison
Part D Standard Benefit Design Parameters:	2006	2007	2008	2009	2010*
Deductible - (after the Deductible is met, Beneficiary pays 25% of covered costs up to total prescription costs meeting the Initial Coverage Limit.	$250	$265	$275	$295	$310
Initial Coverage Limit - Coverage Gap (Donut Hole) begins at this point. (The Beneficiary pays 100% of their prescription costs up to the Out-of-Pocket Threshold)	$2,250	$2,400	$2,510	$2,700	$2,830
Total Covered Part D Drug Out-of-Pocket Spending including the Coverage Gap - Catastrophic Coverage starts after this point.	$5,100.00	$5,451.25	$5,726.25	$6,153.75	$6,440.00
Out-of-Pocket Threshold - This is the Total Out-of-Pocket Costs including the Donut Hole. 2010 Example: $310 (Deductible) +(($2830-$310)25%) (Initial Coverage) +(($6440-$2830)100%) (Cov. Gap) = $4,500 (Maximum Out-Of-Pocket Cost prior to Catastrophic Coverage - excluding plan premium)	$3,600 $ 250.00 $ 500.00 $2850.00 $3600.00	$3,850 $ 265.00 $ 533.75 $3051.25 $3850.00	$4,050 $ 275.00 $ 558.75 $3216.25 $4050.00	$4,350 $ 295.00 $ 601.25 $3453.75 $4350.00	$4,550 $ 310.00 $ 630.00 $3610.00 $4550.00
Catastrophic Coverage Benefit:
Generic/Preferred Multi-Source Drug	$2.00	$2.15	$2.25	$2.40	$2.50
Other Drugs	$5.00	$5.35	$5.60	$6.00	$6.30
Part D Full Benefit Dual Eligible Parameters:	2006	2007	2008	2009	2010*
Copayments for Institutionalized Beneficiaries	$0.00	$0.00	$0.00	$0.00	$0.00
Maximum Copayments for Non-Institutionalized Beneficiaries
Up to or at 100% FPL:
Up to Out-of-Pocket Threshold
Generic/Preferred Multi-Source Drug	$1.00	$1.00	$1.05	$1.10	$1.10
Other	$3.00	$3.10	$3.10	$3.20	$3.30
Above Out-of-Pocket Threshold	$0.00	$0.00	$0.00	$0.00	$0.00
Over 100% FPL:
Up to Out-of-Pocket Threshold
Generic/Preferred Multi-Source Drug	$2.00	$2.15	$2.25	$2.40	$2.50
Other	$5.00	$5.35	$5.60	$6.00	$6.30
Above Out-of-Pocket Threshold	$0.00	$0.00	$0.00	$0.00	$0.00