CMS Releases 2010 Medicare Part D Benefit Parameters
Medicare Part D Parameters
The 2010 parameters below were calculated using the annual percentage increase method. The 2010 annual percentage increase is 4.66%.
Standard Benefit Parameters
Deductible $ 295 $ 310
Initial Coverage Limit 2,700 2,830
Out-of-Pocket (OOP) Threshold 4,350 4,550
Minimum Co-Pays (Catastrophic Portion of Benefit)
Generic/Preferred Drug 2.40 2.50
All Other Drugs 6.00 6.30
Total Covered Part D Spending at OOP Threshold
The amount below represents a beneficiary’s total out-of-pocket expense before catastrophic coverage commences.
Total Out-of-Pocket Expense $ 6,153.75 $ 6,440.00
Retiree Drug Subsidy Amounts
Plan sponsors who qualify for the retiree drug subsidy (RDS) will be required to meet increased cost threshold and cost limit levels for 2010.
RDS Cost Threshold $ 295 $ 310
RDS Cost Limit $ 6,000 $6,300
Thus, the maximum potential subsidy per covered retiree has increased from $1,597.40 to $1677.20.
Effects of New Parameters
Plan sponsors that want to remain qualified for the employer retiree drug subsidy will need to determine if their 2010 prescription drug coverage is at least actuarially equivalent to the 2010 standard Medicare Part D coverage. Those who provide coverage directly or indirectly through a Part D plan may want to review the impact of these new parameters on their plans.
In any event, plan sponsors may want to evaluate whether to move Medicare retirees into other options for medical and/or drug coverage for 2010 as the marketplace continues to develop.
Buck’s consultants would be pleased to discuss the Medicare Part D parameters for 2010, and options for providing prescription drug coverage to your Medicare eligible retirees.
Medicare Guideline posts
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Top Medicare billing tips
URIBEL- methenamine, sodium phosphate, monobasic, monohydrate, phenyls alicylate, methylene blue, and hyoscyamine sulfate capsule Uribel i...
procedure code and description 71250 - Ct thorax w/o dye - average fee payment - $180 - $190 71275 CTA chest (noncoronary) 71260 CT ...
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee...
This post has Most used J code list and we are constantly updating with example . If you are looking particular J code, use search button. ...
Procedure Codes and Definitions 36415 Collection of venous blood by venipuncture - Fee schedule amount $3.10 36416 Collection of capi...
Procedure code and description 93015 (cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ele...
Procedure code and description 95004 Percut Tests w/ Extrac Immed React # Allergy testing - Percut allergy skin tests - Percutaneous ...
Coverage Indications, Limitations, and/or Medical Necessity This LCD describes conditions under which the coverage of nail avulsion/ex...
CPT CODES and Description 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitr...
Flow Cytometry is a highly complex process by which blood, body fluids, bone marrow and tissue can be examined. It provides important immun...