Talk:Medicare Part D coverage gap

message: I like the recent descriptive additions to this page, but they venture more into explanatory editorial territory than fact based Wiki-style writing.  I'd like to keep the basic content if it can be either re-worded to be more objective, neutral and fact-based.  Jargent 14:52, 27 November 2006 (UTC)
thread_title: Neutrality

message: Could we find something to support the $5100 figure?  I've worked with these plans professionally since the privetization and I've never seen this figure come up.  
The gap begins after the $2400 tde cost is met and ends once $3850 trOOP is met.  This isn't the same thing as $5100.  
For instance, it you have $1200 medication with a $200 copay, you'll be in the gap on your second fill, with only $400 towards the $3850.  If you get the med twice again (paying full price), you'll have paid $3200, so your trOOP will be $3200.  On the next fill you will pay $650 (the amount remaining between the 3200 and the 3850) and 5% of the remainder (5% of 550 is $27.50), namely, $677.50.  Add this into our trOOP total and you have 3877.50, which doesn't relate to 5100 at all.  Even if you don't add in the 5% amount (since it's really after the gap) you don't get anything that relates to it.206.213.251.31 19:50, 26 June 2007 (UTC)
thread_title:  $5100? 

message: If they're having to pay for everything, how can they be said to "have" medicare coverage?  —Preceding unsigned comment added by 64.122.63.142 (talk) 14:40, 7 April 2008 (UTC)
thread_title:  I'm confused 

message: Surprised me!  —Preceding unsigned comment added by 148.177.1.215 (talk) 13:46, 8 January 2009 (UTC)
thread_title:  Wow! 

message: I've just moved this article from Donut Hole (Medicare) to Donut hole (Medicare) because my quick review of websites using this term, starting with Medicare.gov itself (see "MPDPF: Glossary: Coverage Gap", indicate that it is not a proper noun. I've also done some copyediting to reduce the excessive capitalization in the material apparently taken from Medicare documentation (which tends to capitalize every Term of Interest) down to Wikipedia's standard sentence case.
Regular readers of this article might want to consider that this article possibly should be titled Coverage gap. Even though "donut hole" is in common use, I suspect it's nearly always mentioned at least once as "coverage gap", even in articles and documents that say "donut hole", whereas the reverse may not be true, and it seems to be the offical name of the phenomenon. ~ Jeff Q (talk) 19:15, 31 March 2009 (UTC)
thread_title:  Title change and copyediting 

message: Under the Details section, the following is stated - "The first $750 of TrOOP comes from a $250 deductible phase, and $500 in the initial coverage limit, in which CMS covers 25% of the next $2000", however, CMS is not defined anywhere within the article that I can see.  It is customary to provide the full definition of an acronym upon first usage when writing to provide the reader who is unfamiliar with an understanding of what the acronym refers to.  A reference explaining what CMS is is needed here.
Howaboutyouthinkaboutit (talk) 06:21, 15 November 2009 (UTC)
thread_title:  What is CMS...??? 

message: I have to say that this is about the worst wikipedia article I have ever read,  confusing, full of bias, over use of acronyms.  Surely someone can write a far better one which actually explains the topic, which I do not have the time to do.
Trudyjh (talk) 19:02, 18 November 2009 (UTC)
thread_title:  confusing article, full of political opinions 

message: The one glaring non-neutral term I saw was the use of the phrase "catastrophic coverage threshold."
This expression seems a bit too sensationalist and dire -- why not just take out the word "catastrophic" and leave it at that?
--Erredmek (talk) 05:30, 23 June 2010 (UTC)
thread_title:  The "catastrophic coverage threshold" 

message: Maybe the government definition of catastrophic should be explained. Note that a person taking six different drugs (which is not unusual for an elderly person) may be catastrophic or not depending on how many of those drugs are generic. If 4 of the 6 drugs are non-generic, that person will fall into the coverage gap very quickly. If all 6 drugs are generic, that person will never fall into the gap.--72.87.182.181 (talk) 18:00, 13 May 2015 (UTC)
thread_title:  Explain Catastrophic 

message: The intro states "...copayments made by the consumer up to the point of entering the gap are specifically not counted toward payment of the costs accruing while in the gap."' 
Can I get a cite to confirm that those copayments made prior to entering the gap period don't count? Mononymous (talk) 16:15, 14 July 2016 (UTC)
thread_title: Clarification on Intro / Citation needed?

message: I think we should merge the sections of 2018 Medicare Part D payments and "Standard Benefit Design" since they pretty much say the same thing.  Lisa nel (talk) 03:55, 6 November 2017 (UTC)
thread_title:  Article Improvement Goals 

message: Overall, the edits made by the pharmacy team reflected a neutral point of view throughout the changes, despite medical coverage being a debatable topic and information can be biased. Information from sources were accurately stated and all data and statistics were written as intended from its sources. However, it is possible that some readers may feel that the editor is criticizing this "donut hole" gap in Medicare Part D since they do provide a lot of information on its shortcomings and how the ACA is trying to resolve it. Since we are healthcare providers, it's natural for us to side with the patient-care aspect and want to promote the best medical benefits for patients. If possible, adding a comment on why such a gap in coverage exists and what were the financial benefits of that decision would enhance the neutral point of view of this article. Perhaps it would raise taxes or take away different services for these patients.
Drake
In conclusion, the edits made by this group was neutral and provided clear and detailed explanation of what the coverage gap is, its impact on patient expenses, and what the ACA has done to cover that gap. I can confidently say this article was enhanced by these edits and will be a valuable resource for patients who may be confused with this gap in their care.
Drake  — Preceding unsigned comment added by Dimsumdrake (talk • contribs) 06:13, 7 November 2017 (UTC)
thread_title:  Peer Feedback: Neutral Point of View 

message: STUDENT 4- Is there evidence of copyright or plagiarism? if so, specify...
After checking the content written and the sources linked; the information is the same, however the information is concise and summarized from a number of resources for the most part. One part of the edit that I would caution is under the section 2018 Medicare Part D Standard Drug benefit; the first line "For 2018, the standard benefit includes a deductible of $405 (the amount that beneficiaries must pay out of pocket before their insurance benefits kick in) and a 25% co-insurance up to the initial coverage maximum of $3,750. " seems very closely to the cited article in KFF. Please compare: In 2018, the Part D standard benefit has a $405 deductible and 25% coinsurance up to an initial coverage limit of $3,750 in total drug costs, followed by a coverage gap.  While it is directly not word for word. I feel weary that it is too closely worded. At the same time, I understand that these numbers and facts are objective information and there isn't a ton of way you can word this. Overall, I like the costs summary table; it really summarizes the secondary sources for readers and makes it easier to understand the complication of the Medicare part D coverage gap. Overall, there is minimal signs of plagiarism, I think my peers did a great job updated this wiki page; the information is easy to understand and summarized for the lay audience compared to some of the secondary sources that this information was extracted from. 
Danh Danhvd (talk) 02:38, 8 November 2017 (UTC)
thread_title:  Peer Feedback: Plagiarism  

message: I feel that the group achieved their overall goals for improvements on adding more background of the ACA, updating the charts, impact of medicare beneficiaries. Especially for the low income subsidy and phase-out sections which were straight to the point easy to read for viewers. AustinW426 (talk) 06:23, 8 November 2017 (UTC)
thread_title:  Peer Feedback: Overall Goals 

message: STUDENT 2 – Are the points included verifiable with cited secondary sources that are freely accessible? If not, specify…
The citations of the pharmacy group were indeed verifiable with secondary sources that were freely accessible. (The only citations missing were one that were of past contributors). While the wording and paraphrasing was not taken well by the wiki community, the citations were all in order. They did a really good job in using sources that were not only accessible, but also (really great) without compromising the credibility of the sources. The first citation source is the best where they cited CMS or "Centers for Medicare and Medicaid Services" which is where the most reliable information about medicare exists. What is really great about this source is that, the wiki page sifts though and explains the CMS website allowing for readers to understand and get a more basic understanding of (in the very least, the terms of) Medicare Part D, and then readers, if they need to sign up or find forms on CMS, are navigated and understand what much of the denser information may mean when they visit the site. Additionally, citing and referencing much of the government websites is extremely beneficial to the reader who may not have been able to find the correct information but also providing a source of contact and contact information too. In addition, the quality of the edits was done well in that they were concise which is key to wiki articles. Changes that can be made would be to make the sentences a little clearer however, such as, "From this point now until 2020, brand-name drug manufacturers as well as the federal government will be responsible for providing subsidies to patients in the doughnut hole," to maybe cut extraneous phrases like into "From 2017 until 2020, brand-name drug manufacturers and the federal government will be responsible for providing subsidies to patients in the doughnut hole."
Sahar Sprinklerose (talk) 07:39, 7 November 2017 (UTC)
thread_title:  Peer Feedback: Cited Secondary Sources 

message: Student 3 - Sean
Overall, the writing was done well, I think with a few minor edits it will be superb. Some of the sentence wording can be changed slightly to improve flow and make it more concise. For example: "In 2010, the Affordable Care Act began providing a $250 rebate check for individuals whose drug expenses took them into the doughnut hole in an effort to close the coverage gap." Could be written as: "In an effort to close the coverage gap, the Affordable Care Act of 2010 provided policy for individuals to receive a $250 rebate check." Not a huge deal, just something to think about in regards to writing style. The group did a good job of catering to the audience, I know nothing about Medicare Part D and I completely understood everything they wrote. There may be a few words that people of less educational background may not understand, but may be up to your discretion (I understood it!). Citations were done properly, and organization was sound. Sean Seanlew9 (talk) 02:45, 8 November 2017 (UTC)
thread_title:  Peer Feedback: Style