Healthcare Reform and Medicare Part-D Doughnut Hole Changes

It is no doubt that over the last week or two, you’ve read articles, watched t.v., or listened to the radio where Healthcare Reform was the main topic.  No matter what side of the fence your on, the bill has passed, and so it is important to understand how it will affect you over the coming years.  This week, we’ll take a look at how Medicare Part D or Medicare Prescription Drug Coverage will be affected.  Here is the breakdown:

  • In 2010, Medicare Part D participants who reach the coverage gap (otherwise known as the doughnut hole) will receive a $250 rebate
  • In 2011, Medicare Part D individuals who reach the coverage gap will receive a 50% discount on brand name drugs, but not until they reach the coverage gap.
  • Brand name drugs will be subsidized slightly more each year between 2011 and 2020, eventually reaching a cost sharing structure of 25% paid by the individual and 75% paid by the plan sponsor (insurance company) in 2020.
  • Generic drugs will be subsidized for those in the coverage gap starting in 2011 at a rate of 7% per year, eventually reaching a cost sharing structure of 25% paid by the individual, 75% paid by the plan sponsor (insurance company) in 2020.

Each year, 14% of all Medicare Part D enrollees fall into the coverage gap or doughnut hole. Often times, this is an avoidable circumstance and one the professionals at Rx Savings Solutions are trained specifically to deal with.  If you’re one of those people paying to much for your medications out of pocket each month, contact us at pharmacist@rxsavingsllc.com today!

Stats were gathered from the Kaiser Family Foundation.  For more information, visit their website at http://www.kff.org/healthreform/upload/8059.pdf.

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