Once the costs that both you and your drug plan have paid exceed the above limit, then you will pay 25% co-insurance for brand drugs in 2019, and your drug plan will pay 5%. There's a manufacturer discount of 70%. For generics, you will pay 37% and plans pay 63%. This phase of coverage — which is called the "doughnut hole" or coverage gap —lasts until you have a spent a total of ,100 out-of-pocket on prescription costs. Please note that what you pay in premiums does not count toward out-of-pocket costs. Once you have spent ,100, which counts the manufacturer discount portion of the drug cost in the doughnut hole, then you reach the Part D catastrophic threshold. Medicare pays 80%, plans pay 15% and enrollees pay the greater of either 5% of total drug costs or .40/.50 for each generic/brand-name drug respectively. .Pet health insurance may not be worth the cost. While many veterinarian practices have brochures for pet health insurance, shop carefully, and read the fine print about what these policies do and don't cover. Pet owners can expect to pay between to per month for premiums, often more than what you pay in services most years. Consumer experts suggest that if you are worried about catastrophic costs, put the money you would spend on pet health insurance premiums into a pet savings account. . Contact your doctor's office and alert them to this dilemma. Ask if they have emergency samples of Lantus and your blood pressure medicine that they can provide, or if they can give you the contact number of programs that can help you. .However, you don't need to read the 265-page report to understand why Medicare is going broke. Last year, Medicare spent 3 billion, but only took in 6 billion—leaving a billion deficit in just one year. With 10,000 new individuals becoming eligible each day, it's only going to get worse. .He predicted that lawmakers will pass a six-month "doc fix" later this month in order to buy more time for the offset discussions. If Congress takes that route, the temporary pay patch would expire at the end of September – the same time that funding for the Children's Health Insurance Program (CHIP) will run out. Rep. Price suggested that a permanent repeal of the SGR would likely be rolled into a package with CHIP's reauthorization. .Congressional inaction on the debt ceiling is a growing concern of TSCL's for several reasons. If a default on the federal debt occurs, Social Security benefits would likely be delayed, and millions of seniors living on fixed incomes would suffer financially. In addition, doctors who treat Medicare patients would likely see postponements in their reimbursements from the federal government, and access to quality medical care would be jeopardized for beneficiaries. .Our next issue of interest this week is Surprise Billing. Surprise billing does not affect seniors on Medicare as much as it affects seniors under age 65 who still have health insurance through their employer or who are paying for their own health insurance. Surprise billing usually refers to expensive, unexpected medical bills that patients receive from hospitals and doctors' offices even when they have health insurance that they expect will cover the majority of treatments cost. Congress has been getting an earful from voters who are very upset about this situation and there seemed to be a fair amount of optimism that legislation dealing with surprise billing may be able to pass. If it does, there could be an effort to attach legislation dealing with drug prices to that bill. .Wages in the ESF since the end of 1999 grew by 3.20 billion to 5 billion, nearly doubling from 1.8 billion. In other words, it took 63 years to accumulate 1.8 billion in wages in the ESF. In the five most recent years, the amount of wages rose by 93%. This growth is illustrated in the charts in Tables 1, 2 and 3, which follow. .Senate Minority Leader Harry Reid (NV) told reporters on Wednesday, "The CR is not done; it's a work in progress … This isn't going to be wrapped up in the next couple hours, that's for sure." In addition, Senator John Thune (SD) said, "I think [Majority Leader McConnell's] goal all along has been to try and get something considered by the end of this week, to try and wrap things up. But I'll just tell you, my own view is that, based on past experience, I don't think we'll get there this week. I think this probably spills into next week."