How will health care reform affect the Medicare Part D ‘donut hole’?
The biggest change to the Medicare Part D program resulting from health care reform is the gradual closing of the Coverage Gap (otherwise known as the ‘donut hole’). As a result of the recently enacted health care reform law, Medicare patients entering the Coverage Gap will pay an increasingly smaller share of their drug costs each year until the Coverage Gap is completely phased out in 2020. At that point, patients only will be responsible for the standard 25% of their drug costs until they reach the threshold for catastrophic coverage, when their co-pays drop to approximately 5%.
