Monday, February 26, 2018

Dunkin' (Medicare) Donuts

We first blogged on the (so-called) Donut Hole in Medicare over a dozen years ago:

"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]"


"I'm from the government..."
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