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Will monthly Medicare Part D premiums increase due to the manufacturer’s discount on brand-name drugs purchased in the Coverage Gap?
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CBO says Yes. The Congressional Budget Office (CBO.gov) has issued the following statement:

“The Patient Protection and Affordable Care Act (PPACA) introduced a manufacturer discount program in Medicare Part D for brand-name drugs purchased in the coverage gap, often referred to as the 'doughnut hole.' CBO assumes this policy would increase the number of Part D beneficiaries receiving catastrophic coverage, since prescription drugs would be more affordable to the beneficiary, causing Part D spending to increase overall. As a result of these changes, [CBO] estimate[s] that Part D premiums would increase by about 3 percent starting in 2011.  …The reconciliation bill would make additional changes to the structure of the Part D benefit.  In addition to the discount program provided by manufacturers, Section 1101 would require that Part D plans cover more prescription drug costs for non-low income subsidy individuals in the doughnut hole over time.  This policy change further increases Part D spending, compared to PPACA, because the benefit is more generous.  Beneficiaries and the federal government share in program costs, which leads to an increase in premiums.  According to CBO’s preliminary estimate, enacting those changes would lead to an average increase in premiums for Part D beneficiaries of about 4 percent in 2011. …However it is important to note that beneficiaries out-of-pocket spending on prescription drugs apart from those premiums would fall, on average, as would their overall out-of-pocket drug spending including premiums."

http://www.cbo.gov/ftpdocs/113xx/doc11379/Comparison.pdf

 




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Related FAQs In This Category
• I have a PACE plan, will I get the discount on brand-name drugs purchased in the Coverage Gap?
• I have a Medicare Part D plan that provides coverage for some generics while I am in the Coverage Gap, will this same Doughnut Hole coverage apply to all generics in 2011?


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Latest Added FAQs

For 2011 you indicate that the full retail cost of drugs while in the donut hole will apply to the amount required to get out for name brands even though I'm only paying 50%. I talked directly with Medicare and they said I will still have the same out of pocket requirements, i.e. it'll just essentially take me twice as long. Can you clarify?
The Medicare representative is correct in saying that your requirement (out-of-pocket cost limit or  . . .

My current prescription drug retail cost are $230 per month. What will be my discount in the Doughnut Hole?
If your total retail prescription medication costs are under $236, you will not exceed&nbs . . .

Can you provide an example of the 2011 Donut Hole Discount?
We have updated our 2011 PDP-Planner (or Donut Hole Calculator) to include the model plan featu . . .

Will monthly Medicare Part D premiums increase due to the manufacturer’s discount on brand-name drugs purchased in the Coverage Gap?

CBO says Yes. The Congressional Budget Office (CBO.gov) has issued the following statement:“Th . . .

I have a PACE plan, will I get the discount on brand-name drugs purchased in the Coverage Gap?
No. The manufacturer discount on brand-name drugs purchased in the Coverage Gap is applied AFTER the . . .





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