Starting with the 2011 Medicare Part D plan year, the co-insurance (or cost-sharing) was reduced for non-LIS Medicare beneficiaries on covered drug purchases in the Coverage Gap (or Donut Hole / Doughnut Hole).
In 2014, you will receive a 52.5% discount on Brand-name drugs and a 28% discount on Generic drugs.
In 2013, you receive a 52.5% discount on Brand-name drugs and a 21% discount on Generic drugs.
See charts below for future year discounts.
Please note, that the Doughnut Hole discount is not available to anyone receiving financial Extra Help (the Low-Income Subsidy). Also the discount is only for Medicare Part D drugs included on your Medicare Part D prescription drug plan formulary.
The Generic drug discount will increase each year until the plan year 2020 when the co-insurance for generics in the Coverage Gap will be 25%. The following table shows how the annual Generic drug discount increases:
|
Plan
Year
|
Beneficiary
Cost-Sharing
|
Plan
Cost-Sharing
|
|
2011
|
93%
|
7%
|
|
2012
|
86%
|
14%
|
|
2013
|
79%
|
21%
|
|
2014
|
72%
|
28%
|
|
2015
|
65%
|
35%
|
|
2016
|
58%
|
42%
|
|
2017
|
51%
|
49%
|
|
2018
|
44%
|
56%
|
|
2019
|
37%
|
63%
|
|
2020
|
25%
|
75%
|
The Brand-Name drug discount operates differently from the Generic drug discount - but the Brand-Name drug discount will also be reduced to co-insurance of 25% by 2020.
|
Plan Year
|
Beneficiary Cost-Sharing
|
Plan Cost-Sharing
|
Manufacturer Cost-Sharing
|
|
2011
|
50%
|
0%
|
50%
|
|
2012
|
50%
|
0%
|
50%
|
|
2013
|
47.5%
|
2.5%
|
50%
|
|
2014
|
47.5%
|
2.5%
|
50%
|
|
2015
|
45%
|
5%
|
50%
|
|
2016
|
45%
|
5%
|
50%
|
|
2017
|
40%
|
10%
|
50%
|
|
2018
|
35%
|
15%
|
50%
|
|
2019
|
30%
|
20%
|
50%
|
|
2020
|
25%
|
25%
|
50%
|
| 
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