Dear Toni: I am fighting liver cancer. I turn 65 in September and am covered under my wife’s health insurance through her employer. I am participating in a clinical trial for a medication that is curing my cancer — it costs over $12,000 per month, but I pay $0.
I am concerned about what to do when I enroll in Medicare and if I will be in Medicare’s infamous “doughnut hole” since this is a clinical trial. I am not planning to enroll in Medicare until my wife, Sarah, retires when she turns 65 in two years. Are clinical trial prescriptions covered under Medicare drug plans? What are my options? — Lincoln, Tampa, Florida.
Dear Lincoln: What a smart decision you made to stay on Sarah’s employer benefits, because you both can enroll in Medicare Parts A and B when she retires at 65. At that time, you will be eligible for a special enrollment period, avoiding a Medicare Part B penalty, and will be able to enroll in a Part D prescription drug plan. She will be enrolling in Medicare during her initial enrollment period.
Exploring Part D and prescription drugs is one of the most important Medicare topics. Lincoln, you would go into the “doughnut hole” the second you order the prescription that costs over $12,000 per month if you were not in a clinical trial. In 2024, the doughnut hole begins once the actual cost of a person’s prescriptions reaches $5,030 and ends when one has spent $8,000 out of pocket; then the catastrophic coverage phase begins.
As of Jan. 1, the n.
