Nearly 4 Million People on Medicare Get Help with Prescription Drug Costs

Prescription drugs have always been notoriously expensive. However, patients should never have to choose between paying for the medical treatment they need and other essentials such as food and housing.

The Centers for Medicare & Medicaid Services (CMS) have implemented provisions so that nearly 4 million seniors have seen reduced out-of-pocket expenses for their prescription drugs. These provisions are far reaching, helping some of the most vulnerable patients in the United States. Nearly one-fourth of Medicare beneficiaries receiving assistance are under age 65 and disabled or age 85 and older.

Thanks to the Affordable Care Act, the Medicare Part D prescription drug program has become stronger and more secure for all beneficiaries by beginning to close the coverage gap, also known as the “donut hole.” The donut hole is a coverage gap for some who get prescription drugs through Medicare Part D. This means that after you and your drug plan have spent a certain amount of money for covered drugs, you have to pay all costs out-of-pocket for your prescriptions up to a yearly limit. Once you have spent up to the yearly limit, your coverage gap ends and your drug plan helps pay for covered drugs again.

Beginning in 2011, the Affordable Care Act provides a 50 percent discount on covered brand name prescription drugs to seniors and others with Medicare who reach the donut hole.

Already this year, nearly 48,000 Medicare enrollees have saved an average of $800 per person. For the 11,000 beneficiaries with the highest out-of-pocket expenses, including patients being treated for cancer and HIV/AIDS, savings have averaged $1, 775. While these Medicare beneficiaries with the highest risks have already seen these discounts, millions more beneficiaries are expected to receive the discount over the course of the year.

Today, the Department of Health and Human Services released a new report on how the Affordable Care Act is helping lower drug costs for people with Medicare. Read the report here.

To find out more about the benefits available to Seniors under the Affordable Care Act, please check out our video: