Medicare Part D
Medicare Part D covers prescription drugs. The Affordable Care Act changed Medicare Part D to increase what Medicare pays and lower what you pay. Another change is that the coverage gap -- or 'donut hole' -- will be closed by 2020.
The 'donut hole' refers to the gap in coverage when you were required to pay 100% of the cost. This typically happened when your drug costs reached $2,831 and lasted until you spent $6,440. This affects about 4 million seniors.
The new law will closes the 'donut hole' by 2020.
You received a $250 rebate check in the mail if:
- You fell into the gap, and
- You did not receive any other help paying for your prescriptions through programs such as Medicare Extra Help
In 2011, while in the gap you paid:
- 50% of the cost of brand-name prescription drugs
- 93% of the cost of generic drugs
Between 2012 and 2020
Every year, after you pay your deductible, you will spend less before Medicare coverage kicks back in.
|Year||% You Pay for Brand-Name Drugs||% You Pay for Generic Drugs|
In 2020, you will pay 25% of all your drug costs. Medicare will pay the difference. That means after you pay your deductible, you will pay only 25% of the cost for prescription drugs up to $6,400. Medicare will pay all costs after that.