2014 Government Regulations & Business Summit
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By PBN Staff
By PBN Staff
PROVIDENCE – Seniors and disabled persons in Rhode Island with Medicare prescription drug plan coverage saved $7.2 million, or an average of $677 per person, on their prescription drugs in the first 10 months of 2013 through the Affordable Care Act’s Medicare discount program, the Centers for Medicare & Medicaid Services reported Tuesday.
In total, 10,561 beneficiaries of Medicare in Rhode Island have saved $28.5 million since passage of the Affordable Care Act in 2010, the CMS said, contributing to $8.9 billion in Medicare savings nationwide.
In Massachusetts, 52,059 Medicare beneficiaries have saved $40.3 million, or an average of $774 per person, in the first 10 months of 2013, with total savings of $141.5 million since the Affordable Care Act was enacted.
“Protecting seniors from the dreaded donut hole and high prescription drug costs is an important Affordable Care Act reform that Medicare beneficiaries have come to depend on,” said CMS Administrator Marilyn Tavenner in a release. “Today’s data shows that the law is already helping millions of seniors save billions of dollars off their needed medications.”
The “donut hole” refers to a gap in the Medicare prescription-drug benefit before catastrophic coverage for prescriptions takes effect. Without Affordable Care Act assistance, many people enrolled in Medicare Part D would pay out-of-pocket for the entire cost of prescription drugs once they hit the donut hole, or would have to purchase secondary insurance to cover their drug costs until they reach catastrophic coverage.
Under the Affordable Care Act’s Medicare Coverage Gap Discount Program, companies that manufacture brand-name prescription drugs must sign agreements with Medicare requiring the companies to offer discounts on brand-name drugs to people who have reached the donut hole. These discounts are offered for more than 99 percent of brand-name drugs used by people with Medicare, and the full cost of every brand-name drug counts toward the amount needed to qualify for catastrophic coverage, on the other side of the donut hole.
For generic drugs, under the Affordable Care Act Medicare pays a percentage of the generic-drug price for beneficiaries in the coverage gap. The amount beneficiaries pay will decrease each year until the gap is effectively closed in 2020.
Since the enactment of the Affordable Care Act, more than 7.3 million seniors and people with disabilities in the U.S. who reached the donut hole in their Medicare Part D plans have saved $8.9 billion on their prescription drugs, an average of $1,209 per person since the program began.
During the first 10 months of 2013, nearly 3.4 million people nationwide saved $2.9 billion, an average of $866 per beneficiary. These figures are higher than at this same point last year, when 2.8 million beneficiaries had saved $1.8 billion for an average of $677 per beneficiary, according to the CMS report.
In 2014, the CMS said, Medicare Part D beneficiaries who fall into the donut hole will receive savings of about 53 percent on the cost of brand-name drugs and 28 percent on the cost of generic drugs.
In addition, the CMS said, the Medicare Part B premium will not increase in 2014, a result of the Affordable Care Act’s efforts to keep cost growth low. The Part B premium and deductible for 2014 are 15 percent below what was projected in 2010, the CMS said.
Since passage of the Affordable Care Act, the CMS estimates that the life of the Medicare trust fund has been extended by nearly 10 years, until 2026.