Law Has Already Saved $260 Million, Averaging $545 for People in Donut Hole
Thanks to the Affordable Care Act, nearly 500,000 people with Medicare Part D who reached the gap in coverage know as the “donut hole” have received an automatic 50 percent discount on their covered brand name prescription drugs. The Centers for Medicare & Medicaid Services (CMS) posted data today that shows 478,272 Medicare beneficiaries have benefitted from the 50 percent discount in the first five months of 2011. These beneficiaries saved a total of $260,534,102, or an average savings of $545 per beneficiary.
The number of seniors benefiting from this discount continues to grow. In the month of May alone, the total number of beneficiaries who received the discount rose by over 76 percent, while the dollar amount of savings rose by over 56 percent. Based on data from past years, CMS expects that as many as 4 million additional beneficiaries will fall into the coverage gap later this year and benefit from these discounts.
Most of these discounts are helping Americans with serious medical conditions – nearly 14 percent of the benefits provided to date – more than $36 million – are for cancer drugs, more than 8 percent or $21 million for drugs to help control high blood pressure and cholesterol, and another more than 7 percent – about $20 million – are for drugs provides to diabetic patients.
“Without the Affordable Care Act, many seniors and people with disabilities would pay twice as much for their prescription drugs in the donut hole,” said CMS Administrator Donald M. Berwick, M.D. “People on Medicare will now be able to better afford their medicine, and these discounts will continue as coverage in the gap grows until the donut hole is closed.”
A November 2010 analysis by the U.S. Department of Health and Human Services estimated that Medicare improvements in the Affordable Care Act would provide average savings for those enrolled in traditional Medicare totaling more than $3,500 over the next 10 years, with even higher average savings of as much as $12,300 for those with higher drug costs.
For more information on how the prescription drug discount and other provisions of the Affordable Care Act benefits seniors and people with disabilities, visit www.HealthCare.gov.
People with Medicare can learn more about these new benefits, including new free preventive benefits and other helpful information by contacting customer service representatives at 1-800-MEDICARE (1-800-633-4227 toll free) or by visiting www.Medicare.gov.
Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
