Congratulations! Your Situation is Catastrophic!

101_2532Never did I think that being in a catastrophic situation would be a good thing, but when it comes to Medicare and prescription drug coverage, it isn’t bad.

Since Steve is permanently disabled, last year he became eligible for Medicare. We selected a Medicare Advantage plan.  His plan has four drug payment stages, but Stage 1 does not apply to Steve’s plan, so he starts in Stage 2. He stays in that stage until year-to-date “total drug costs” reaches $2,970.

At the end of Stage 2, we’ve hit the “donut hole”, or Stage 3. This means Steve receives limited coverage, and he stays there until we’ve paid $4,750 in out-of-pocket costs. Stage 4 is called “Catastrophic Coverage” and here most the plan pays most of the cost for the covered drugs. I knew our costs would reach this point this year, but I didn’t know when.

Well, we’ve hit it already! It’s sort of a “Good grief!” feeling but paying the bill at the pharmacy last night was exciting! A prescription that last time cost  over $250 for a two month supply only cost $27 for the same amount last night. Yeah!!

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6 Comments on "Congratulations! Your Situation is Catastrophic!"


Profile photo of Pegi
Member
Jul 26, 2013

GJ, I know right where you’re at. Love the other side of the donut hole; always a good day when we hit it! My husband is on about 11 RX’s,losing count with recent changes. Celebrate!!! :) I must admit, your title scared me when I saw it! Glad the news is good.

Profile photo of ejourneys
Member
Jul 26, 2013

Congratulations on crossing the donut hole! I get that feeling when my partner has met her deductible, which she does without fail every year.

Profile photo of Trish
Member
Jul 26, 2013

Yay for catastrophic!! What a relief when you hit that threshold. I say you celebrate with a donut. :-) (Hey, you got my mind on donuts!)

Profile photo of Kathy
Member
Jul 26, 2013

Oh my G-J,

I don’t know if I should laugh or cry!
It feels bad to feel good about something bad that makes a situation good.

Profile photo of Denise
Admin
Jul 27, 2013

Your headline just makes me laugh. I, too, am kinda crying and laughing about this. :( :)