The impact of filling the donut hole

Medicare Part D has a confusing benefit system. Prior to 2011, patients had a deductible, then a general coverage benefit (with 25% coinsurance) then a donut hole (with no coverage) and then catastrophic insurance (with a 5%) copayment. When the Affordable Care Act passed, it aimed to fill the donut hole. Beginning in 2011, Part…

How much does the U.S. federal government pay for pharmaceuticals?

A number of different federal agencies buy prescription drugs. However, the price at which these pharmaceuticals are purchased varies dramatically. To quantify this variation, a 2021 report from the Congressional Budget Office examines the following prices: Medicare Part D: the prescription drug program for Medicare beneficiaries. Prices are set when private insurers (or pharmacy benefit…

Part D Fun Facts

Some fun facts from Kaiser Family Foundation about Medicare Part D, which covers prescription drugs. Enrollment has doubled since Part D’s inception in 2019. Enrollment in managed care drug plans (i.e., Medicare Advantage Part D Plans [MA-PD]) has continued to grow, but enrollment in stand alone Part D Plans [PDP] has leveled off or decreased.…