Medicare
| Medicare and the Donut Hole
The coverage gap, better known as the Donut Hole for Medicare part D, starts after a beneficiary reaches the $2840.00 in prescription drug cost. The $2840.00 of drug cost is not representative of what the Medicare recipient pays, but is the total negotiated cost of the drug by a Medicare Provider such has UHC or Humana. The Patient Protection and Affordability Act of March 2010 gave rebates of $250.00 to persons that reached this mark. Going forward starting in 2011, anyone reaching the $2840.00 of cost will receive a $50% and 7% discount on brand name and generic formulary drugs respectively. With the Patient Protection and Affordability Act, (PPAA), the Nation’s first publically funded long term care program was enacted. Through this program, after contributing to Medicare monthly for 5 years, a beneficiary would receive about $50/day to live at home rather than in a Nursing home. Prior to the act, there was bias with Medicare and Medicaid that only entitled Medicare recipients to receive funds for long term care if they stayed at home. |
