highline56 op ed

It is not obvious what costs go into figuring when you have exhausted the first $2250 of "expense" and enter the donut hole, where you pay it all, and the magic figure $$5100, after which you pay only 5% of the cost, so it is worth going over it in more detail. The "expense" is whatever your insurer charges for each particular drug. That varies by insurer, sometimes a lot. One insurer might charge $200 a month for your particular mix, while another might charge $225. You might think that that means the difference is only $25 a month, and your portion only a fourth of that, or $8. Unfortunately, the difference is a lot more than that.

With the $200 charge you will last 11 1/4 months before you pay the full price. So that last month you will pay $150 more than you have been paying. With $250 charge you last only 10 months, and get hit with the full charge for 2 full months. And that is $500! On the government web site that is factored in to calculating the annual cost, but you will have to dig to find the actual charges used by the insurer. That is shown at the bottom of the detail cost page, and only when you click on "show detail".

Just to repeat, the charges used in these calculation are NOT the "you will pay" numbers on the pharmacy list page, and NOT what you have been paying before January 1.