Congratulations! Your Situation is Catastrophic!
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!!