How is the $2000 MOOP calculated?

[Gwen Redington]

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That's about it. I think UHC is the only one who got it right. They explained it like this--- They base the MOOP on the standard coinsurance of 25% or something like that. Take a tier 3 drug. If it's $47/month copay, but 25% of the retail cost of the drug is more like $100 they'll credit the $100 toward the MOOP. So some people will pay 2K and reach the MOOP and some will pay far less. According to Sunfire calculations, I have a lady and her husband who will hit the MOOP in October and neither one of them will pay more than 8 or 900 for the year.

All the other companies I went to training said it was actual MOOP. I haven't look on medicare.gov to see what they say.

 

[axeman462]

just show the customer the print out from drug cost calculator you use (S&S, Medicare .gov etc..), walk them through it, and let the print out do the math for you.