Doughnut Hole

[insurance0707]

Hi, I have a client that meets the gap in coverage in the 6th month on his prescriptions. He has a MAPD. I'm trying to help him avoid the gap. Does anyone know if he got a 90 day supply in Jan on his meds and then got another 90 day supply in March on his meds and then switched over to a PDP and a Medicare supplement to get him through the last 6 months of the year with no gap in coverage if this would work. Would the new PDP plan give him the full $2,510 in benefits?

If anyone knows the answer to this I'd appreciate it.

 

[GreenSky]

The answer is no.

Rick

 

[dandan]

lol

 

[insurance0707]

These are individual prescription plans issued by individual companies. Has anyone contacted a PDP company, Medicare, etc. to see what there response is...ever? I guess I'll call Medicare tomorrow and inquire. Thanks dandan for your informative response. You were a big help

 

[dandan]

Sorry to hurt your feelings, I was not laughing at your question I was laughing at greens response.

 

[GreenSky]

These are individual prescription plans issued by individual companies. Has anyone contacted a PDP company, Medicare, etc. to see what there response is...ever? I guess I'll call Medicare tomorrow and inquire. Thanks dandan for your informative response. You were a big help

Yes, I did contact carriers who informed me that the amount spent under one plan does "carry over" into any other plan for that year.

What I don't know is how the new carrier learns about the amount previously spent.

Your question was if this would work. Officially, it would not.

Rick

 

[Mc1ark]

Woah, I guess it is what it is. There is no way to sugarcoat it.

However w/ some MAPD plans here in South Carolina you have a little help with just generic coverage thru the gap. Maybe that may help a little bit?

 

[Frank Stastny]

I had a client called me last night and said she was going to switch her drug program to Aetna. She said an Aetna rep told her that she can get preferred drugs through the gap if she does.

Does anyone sell for them?

 

[dandan]

I think its preferred generic drugs, not brand.

 

[honestagent]

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