Catastrophic Benefits

(redirected from Catastrophic Benefit)
A 2nd tier of health insurance or health care plan benefits that are ‘activated’ once the benefits have been exhausted from the 1st tier, after which coverage is provided under the catastrophic portion of the policy or plan, in which ‘deductible’ fees must be paid and co-payment requirements met
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The forecast comes despite the fact that total Part D costs per capita grew by almost 11% last year, an increase that was driven largely by high-cost specialty drags and their effect on spending in the catastrophic benefit phase.
* A catastrophic benefit for severe disabilities often can be added as an option;
There [are] no premiums, no gap, a minimum copay, no deductible, and a full catastrophic benefit." Medicare also needs input on how it could interact with physicians on formulary changes, such as matching the formulary with the patient's current drug list.
This gap in coverage is often referred to as the Part D "doughnut hole." However, after $5,100, Medicare's catastrophic benefit kicks in and the beneficiary then only pays the monthly premium plus a 5% co-pay on drug costs.
Finally, the Senate Republican plan provides an option for the self-employed to obtain a basic catastrophic benefit coverage plan.
Chart 1--Medicare Part D Basic Benefit Costs Coverage Drug Costs Beneficiary Pays Deductible $250 $0-$250 100% Initial Benefit $251-$2,250 25% Coverage Gap $2,251-$5,100 100% Catastrophic Benefit Over $5,100 5% Coverage Medicare Beneficiary's Part D Pays Cumulative Total Cost Deductible $250 Nothing $250 Initial Benefit 75% $750 Coverage Gap Nothing $3,600 Catastrophic Benefit 95% $3,600 plus 5% above $5,100 Chart 2--2005 Health and Human Services (HHS) Poverty Guidelines Persons 48 States Alaska Hawaii in Family and D.C.
A catastrophic benefit would cover some of the costs for people who exceed that cap.
Nonetheless, an unprecedented number of senior citizens are making it clear to Congress that they do not want the catastrophic benefit with its hefty premiums--which fails to address their concern over long-term health care costs.
Additionally, the cost of providing such catastrophic benefits could be reduced through the addition of an early duration deductible that vanishes over time.
* It can have catastrophic benefits that will pay out for cancer, heart attacks and strokes; life insurance can help even when you don't die.

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