If the annual deductible
had not yet been met, the employee might pay the full cost, whereas if the deductible had been met, the plan might pay all or nearly all of the cost.
Based on the above guidelines, annual out-of-pocket costs for a Part D beneficiary will be, as of today's date, $3600 ($250 annual deductible
, 25% coinsurance) to reach the catastrophic threshold.
Families must have an annual deductible
of at least $2,000 (a deductible or deductible between $2,000 and $5,000 works well for individuals and families).
In their main findings the MLA'S noted that "wages and salaries, new technology, prescription drugs and a growing and aging population are the main cost drivers in Alberta's health care system," and recommend that "those with a greater ability to pay should contribute more than those with a lesser ability," including combining premiums with an annual deductible
based on the ability to pay.
Under the law, which takes full effect in 2006, low-income seniors will be offered an optional coverage that includes a $35 a month fee, plus a $250 annual deductible
for prescription drugs.
Participation in the program is voluntary and requires a monthly premium of $35 and an annual deductible
However, there's an annual deductible
of $300 for individuals and $600 for families.
The full benefit begins in 2006, with a $35 monthly premium and a $250 annual deductible
covering 75% of drug costs to a maximum of $2,250.
Those at 135%-150% of poverty level would pay a reduced monthly premium and a $50 annual deductible
and would have no gap in coverage.
Family members who use the point-of-service option are responsible for paying the annual deductible
of $300 per member or $600 per family, and 50 percent of the TRICARE allowable charge once the deductible is met.
In turn, after they've exceeded a low annual deductible
of $100, Medicare covers 80 percent of their everyday medical bills.
Traditional coverage includes a $500 annual deductible
and 20 percent copayment on the next $5,000 in expenses, for a maximum out-of-pocket payment of $1,500 per year.