"The donut-hole comes into play whenever a covered person (“beneficiary” in Medicare parlance) reaches a specific threshold, and leaves that person without prescription drug cover until another threshold is reached."
And it's a big problem for seniors, since that demographic tends to use a lot of meds.
Recently, our friends at Cornerstone alerted us that:
"For Medicare Part D beneficiaries with high prescription drug expenses, the “Doughnut Hole” means they pay more for their medicine once costs reach a certain threshold. Narrowing each year since the Affordable Care Act was passed in 2010, the gap was scheduled to close in 2020. With the 2/16 budget deal, the doughnut hole will now close in 2019."
So, good news, right?
Well, maybe not. As co-blogger Bob V explains:
"Medicare drug donut hole to close in 2020 as part of Obamacare. Trump closed a year earlier in latest budget deal. Carriers are unhappy because they will have to pay more for drugs. Also CMS trying to shift expensive drugs currently covered under Part B to Part D."
To which I (who should have known better), replied:
"Ah. Well too bad for the carriers, but seems like okay for insureds?"
(Yeah, dumb)
Bob put it to rest:
"Rule #1. Carriers don't pay for higher costs.
Consumers do.Higher premiums, copay's, deductibles, OOP [out-of-pocket]"
Yup.
"I'm from the government..."
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