Falling into the Doughnut Hole

May 21, 2010 at 5:35 pm Leave a comment

DoughnutAs anyone who has Medicare Part D knows, the doughnut hole (the gap in drug coverage during which people with Medicare must pay the full cost of their prescriptions out of pocket) is a potential problem. The recently-passed healthcare overhaul has provisions in it to close the doughnut hole by 2020 in incremental steps.

Consumers who hit the doughnut hole (sometimes referred to as the donut hole or the coverage gap) in 2010, will receive a $250 rebate. Starting in 2011, the consumer will be responsible for a reduced percentage (less than 100%) of the medication’s cost and the amount the consumer is responsible for will be reduced incrementally until it reaches 25% in 2020, effectively closing the doughnut hole.

Please note however, that the phase-out works differently for brand-name and generic drugs.

The Medicare Rights Center (a national, non-profit organization) has developed a timeline about the closing of the doughnut hole for brand-name drugs and one for generic drugs; those timelines are available at www.medicarerights.org/pdf/Closing-the-Doughnut-Hole-Chart.pdf.

By Tony Trott, ECNV Peer Mentor & Editor
Article from the ECNV Declaration (Spring 2010 Edition)


Entry filed under: Newsletter - The ECNV Declaration. Tags: , .

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