Medicare News

Closing the prescription drug “donut hole”

The Affordable Care Act makes Medicare prescription drug coverage more affordable by gradually closing the gap in coverage where beneficiaries had to pay the full cost of their prescriptions out of pocket, before catastrophic coverage for prescriptions took effect. The gap is known as the donut hole. The donut hole will be closed by 2020.  

 

Because of the health care law, in 2010, anyone with a Medicare prescription drug plan who reached the prescription drug donut hole received a $250 rebate. In 2011, beneficiaries in the donut hole began receiving discounts and savings on covered brand-name and generic drugs. People with Medicare Part D who are in the donut hole in 2016 will receive discounts and savings of 55 percent on the cost of brand name drugs and 42 percent on the cost of generic drugs.

 

For state-by-state information on discounts in the donut hole, go to: https://downloads.cms.gov/files/Part%20D%20dount%20hole%20savings%20by%20state%20YTD%202015.pdf.

For more information about Medicare prescription drug benefits, go to: http://www.medicare.gov/part-d/.

 

Medicare preventive services

The Affordable Care Act added coverage of an annual wellness visit and eliminated coinsurance and the Part B deductible for certain recommended preventive services covered by Medicare, including many cancer screenings and other important benefits. By making certain preventive services available with no cost sharing, the Affordable Care Act removes barriers to prevention, helping Americans take charge of their own health and helping individuals and their providers better prevent illness, detect problems early when treatment works best, and monitor health conditions.

 

For state-by-state information on utilization of an annual wellness visit and preventive services at no cost to Medicare beneficiaries, please visit: https://downloads.cms.gov/files/Beneficiaries%20Utilizing%20Free%20Preventive%20Services%20by%20State%20YTD%202015.pdf.

Source: CMS.gov

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