Medicare patients in Florida have received discounts and rebates of $1.3 billion on prescription drugs in the six years since enactment of the Affordable Care Act in 2010, the Obama administration reported this week.
The ACA, also known as Obamacare, included changes to Medicare’s prescription drug coverage that gradually reduce the out-of-pocket costs for patients insured under the federal health program for people age 65 and older, and the disabled.
Medicare prescription plans used to stop paying once a member’s drug costs reached an annual limit, until their spending reached a “catastrophic” level and coverage kicked in again. That coverage gap is known as the “donut hole.”
In 2016, that gap begins when a Medicare member’s drug costs reach $3,310 on covered drugs. It ends when that member reaches the out-of-pocket limit of $4,850.
The ACA closes the gap by providing rebates and discounts to beneficiaries in the donut hole. The discounts increase each year until 2020 and count as “out of pocket” costs that help beneficiaries get out of the coverage gap faster.
People with Medicare Part D who are in the donut hole in 2016 will receive discounts of 55 percent on the cost of brand name drugs and 42 percent on the cost of generic drugs.
The Obama administration estimates that, under the ACA, the donut hole will be closed completely by 2020.