As part of my “Dedication to Pharmacy”, I am going to create some patient handouts that you can give to your patients to explain things that you don’t want/have to. Whether you give these out is by your own professional judgment, HOWEVER I will not be responsible/feel bad if your patient takes his/her business elsewhere.
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You have been given this information handout courtesy of “The Angry Pharmacist” (http://www.theangrypharmacist.com) because you are unable to understand simple spoken concepts. Your caring pharmacist:
__________________________________________________ BS PharmD (circle one)
has decided that you are not worth his her (circle one) time to explain this concept to you. They have probably explained this to you for the past 4 years, but since you are old and dense, they are unable to take the blank cow-eyes(tm) stare yet again as they waste their breath. Talking to the sky or filtering pee out of the ocean would be a less monumental task than trying to explain Medicare Part D concepts to you, so they have given you this handout so you may study it during the commercial breaks of Jag reruns.
Since January 1st (the start of the new year, the last big party you attended where people said HAPPY NEW YEAR), your deductible has reset.
***TAKE DEEP BREATH, AN EXTRA ARICEPT, AND PREPARE YOURSELF FOR SIMPLE YET SOMEHOW CONFUSING CONCEPTS***
DEDUCTIBLE (DEE-DUCT-A-BULL) is a dollar (meaning money) amount that YOU MUST PAY before your insurance kicks in. Think of it as PAYING $15 before you EAT AT HOMETOWN BUFFET. That’s right, you must PAY MONEY (COPAYS) BEFORE YOUR INSURANCE KICKS IN. Usually DEDUCTIBLES range from 200 to 300 dollars. If you have no idea what your deductible is, your pharmacist cannot help you, call the 1-800 number on the back of your card (the plastic thing with the colors and numbers on it. No, not your red-white-blue one, the other one. No, not the one from last year, THE NEW ONE YOU JUST GOT. That one!)
Remember that no matter how angry you get, and how much you ask, your pharmacist does NOT KNOW what your deductible is! We can guess; but you can also crap your pants, both of which benefit us mutually.
*** WATCH OUT! HERE COMES THE HARDEST CONCEPT OF THEM ALL! ***
DOUGHNUT HOLE (PASTRY – WHAT YOU POOP OUT OF). When you hit a set dollar amount, your insurance cuts out until you have reached another dollar amount, then it kicks back in.
- January 1st hits (Remember? Happy new year? Party?)
- You pay $250 IN COPAYS to get your insurance to work (DEDUCTIBLE).
- You can get drugs FOR ALMOST FREE until the cost of the drugs (NOT YOUR COPAYS) hits $2400
- Your insurance CUTS OFF AND YOU PAY EVERYTHING until the cost of the drugs (NOT YOUR COPAYS) hits $5100.
- Blame the pharmacist and the world for taking food out of your mouth because you are on a fixed income.
- Once you hit over $5100 in DRUG COSTS (NOT YOUR COPAYS), Your insurance MAGICALLY RETURNS LIKE JAG and pays ALMOST EVERYTHING!!!!!!!! until the end of the year. Break out the Geritol and Viagra!
|Total Drug Spend||TrOOP||Out of Pocket Cost||Portion Covered by Medicare|
|$0-$250||$0-$250||Deductible is out-of-pocket||No Medicare Coverage of Costs|
|$250-$2,250||$250-$750||25% out-of-pocket||75% Covered by Medicare|
|$2,250-5,100||$750-$3600||All costs are out-of-pocket||No Medicare Coverage of Costs|
|over $5,100||over $3600||5% out-of-pocket||95% Covered by Medicare|
** OH NO! CONFUSING WORDS! **
The TrOOP above stands for True Out Of Pocket (Get it?) cost. That is YOUR COPAYS!
- Total Drug Spend = How much the medication costs if you were to pay cash like only chumps and idiots do
- TrOOP = Your COPAYS. The TRUE Out of Pocket. What you pay the nice pharmacist to pick up your medication! Cue Fixed Income/I cant afford $1.10/whining and bitching.
REMEMBER (hahahaha), The pharmacist is here to make sure that YOU DON’T DIE FROM MEDICINE (*sigh*), not FIX YOUR INSURANCE. That is YOUR JOB because you decided to listen to the nice salesman who lied to you and got your plan all messed up instead of your nice pharmacist who TOLD YOU TO STAY WITH YOUR CURRENT PLAN. Remember that? Of course you don’t.
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