The number of Medicare Part D beneficiaries who reach the catastrophic coverage phase of the prescription drug benefit rose by more than 50% between 2013 and 2016, according to an analysis released today by Avalere. The study looked at the 72% of Part D beneficiaries who do not receive low-income subsidies and found more than 800,000 entered the catastrophic coverage phase in 2016, up from about 515,000 in 2013. “Beneficiaries who reach the catastrophic coverage phase have spent thousands of dollars out-of-pocket on prescription drugs,” said Avalere President Dan Mendelson. “Because Part D has no out-of-pocket maximum, these patients will continue to face additional costs throughout the year.” Once in catastrophic coverage, beneficiaries pay up to 5% of their drug costs while the government pays 80% and the Part D plan 15%.

Related News Articles

Headline
The Medicare Payment Advisory Commission Friday released its March report to Congress.
Perspective
As our country works to expand health coverage and improve access to care, “Medicare for All” is getting a lot of attention. There are many different flavors…
Headline
Legislative proposals for a Medicare public option could negatively affect patient access to care and significantly reduce payments to hospitals, AHA Executive…
Insights and Analysis
This week, as part of the South by Southwest (SXSW) festival’s Interactive Health and MedTech track, the American Hospital Association and hospital leaders…
Headline
Creating a government-run, Medicare-like option on the individual health insurance exchanges could negatively affect patient access to care and reduce hospital…
Headline
The House Energy and Commerce Health Subcommittee today held a hearing on the president’s fiscal year 2020 budget request for the Department of Health and…