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Medicare Doughnut-Hole Costs Decreasing: What to Expect

August 2, 2010

The health-care reform law is doing away with the Medicare doughnut hole–eventually. Right now, drug coverage stops after about $2,830 is spent on medications. It starts up again once you rack up $4,550. Medicare expert Joe Baker explains what’s in store for this coverage gap, and–perhaps more important for people caring for aging parents–what to expect in the meantime:

The health reform law will phase out the coverage gap by 2020. In 2010, Medicare will automatically send eligible people who enter the coverage gap a one-time $250 rebate. People with Medicare who receive Extra Help will not be eligible for this rebate. …

In 2011, consumers will receive a 50 percent discount on brand-name prescription drugs and a 7 percent discount on generic drugs when they are in the doughnut hole. The share that consumers pay for both brand-name and generic drugs will decrease until the gap is eliminated in 2020.

Baker’s answer appears in part four in a series of Medicare questions and answers The New York Times has been featuring in its blog Bucks. We previously covered parts one and two. Here are installments three and four.

If you have any questions about this post or need help finding senior-care options for a loved one, call 1-866-483-4896 to speak with a care advisor in your area.

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