Medicare Donut Hole in 2013: Most Will Not Hit the Coverage Gap

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For beneficiaries who are enrolled in Medicare Part D plans, there is the chance each year that they may fall into the coverage gap, also known as the Medicare “donut hole.” Within this gap, they must pay for all costs of their prescription drug usage out of their own pocket, with the help of some government subsidies and manufacturer discounts on generic and brand-name medications. A recent eHealth study has found that the majority of beneficiaries will not reach the Medicare donut hole in 2013.
Source: ehealthmedicare.com

Video: 2014 Medicare Doughnut Hole Costs – Donut Hole Costs for 2014

Medicare donut gap to close significantly

That means the vast majority of seniors— 91 percent — will not hit the Medicare prescription drug donut hole at any time in 2013. Among users who will hit the donut hole in 2013, nearly two-thirds (62 percent) will hit the donut hole between September and December in their existing Medicare prescription drug plan.
Source: benefitspro.com

Health law gives seniors stronger safety net, closes Medicare ‘doughnut hole’

Since 2010, the tab on your doughnut-hole drugs has dropped through steady discounts. Next year, expect to pay 47.5 percent of the price of brand-name drugs and 72 percent of the tab for generic drugs. By 2020, Obamacare will declare the doughnut hole closed and you will continue to cover just 25 percent of both brand-name and generic drug costs.
Source: alpha-1foundation.org

The Windy Road To Closing the Donut Hole and the Future of Medicare Part D Under Obamacare

In the beginning, Medicare did not offer a prescription drug benefit and tens of millions of seniors paid for their medications entirely out-of-pocket. Let there be light: In 2003, Congress passed the Medicare Modernization Act, which was then signed into law by President Bush. That law gave birth to Part D – a prescription drug benefit available to Medicare enrollees. But there were holes! When Medicare Part D plans first launched in 2006, average monthly premiums were $25.93. After paying a standard deductible of $250, enrollees paid 25% of their drug costs until total drug costs (between the enrollee and insurer) reached $2,250. That’s $250 towards the deductible, $500 in cost-sharing, plus premiums of $311.16 for a total of $1,061.16 per year in out-of-pocket spending. That’s if you stayed out of the donut hole!
Source: pharmacycheckerblog.com

How Will Health Reform Affect Medicare? Part D, Donut Holes, Limits, and More

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Source: webmd.com

FAQ: The Shrinking Medicare Doughnut Hole

Drug plans vary, but here’s generally how it works: After paying a deductible of $310, beneficiaries with Medicare drug coverage are responsible for 25 percent of the cost of their prescription drugs; the drug plans pick up the other 75 percent, explains the National Council on Aging. Once the seniors run up an additional $2,530 in costs – of which $632.50 is paid by the senior and $1,897.50 is picked up by the drug plan – the beneficiaries enter the doughnut hole. At that point, beneficiaries are fully responsible for their drug bills. To soften the blow, under the law, seniors this year will get a 50 percent discount on brand-name drugs and a 7 percent discount on generic drugs until they have spent an additional $3,607.50. At that point, seniors escape the doughnut hole and the drug plan covers about 95 percent of the cost of prescriptions for the rest of the year.
Source: kaiserhealthnews.org

Medicare Part D Prescription Drug Plans

If you select “Keep me signed in on this computer”, you can stay signed in to WebMD.com on this computer for up to 2 weeks or until you sign out. This means that a cookie will stay on your computer even when you exit or close your browser which may reduce your levels of privacy and security. You should never select this option if you’re using a publicly accessible computer, or if you’re sharing a computer with others. Even if you select this option there are some features of our site that still require you to log in for privacy reasons.
Source: webmd.com

Tips to Lower Costs in the Medicare Part D Donut Hole

In a previous post, we discussed how many beneficiaries enrolled in a Medicare Part D Prescription Drug Plan (PDP) and Medicare Advantage Prescription Drug Plans (MAPDs) will enter the coverage gap, also known as the “donut hole,” at some point during the year. Around half of Part D beneficiaries reached the coverage gap by the end of August, and those that entered it in July remain in the coverage gap until the end of the calendar year. Increased costs in the donut hole have lead to reduced drug usage, which poses an obvious problem for the health of beneficiaries. This post will offer some tips on how to save money while in the Part D donut hole.
Source: planprescriber.com