Medicare Part D Enrollees Spending Much More For Their Drugs

Medicare Part D: Drug Plan


One million Medicare beneficiaries had out-of-pocket prescription drug spending above the Part D catastrophic threshold in 2015. Indeed, the number with such high spending has risen sharply in recent years,  as reported today by the Kaiser Family Foundation.


medicare part d


Medicare Part D: Prescription Drug Costs

Although the Part D drug benefit has lowered the cost of prescription drugs for people with Medicare, the lack of a hard spending cap exposes enrollees to significant costs. The only way to avoid increases is to qualify for low-income subsidies. The standard Part D benefit includes a catastrophic coverage threshold above which enrollees pay up to 5 percent of their total drug costs out-of-pocket.


Medicare Part D: Comparison Drug Costs

For example, in 2015, 3.6 million Medicare Part D enrollees had total drug spending above the catastrophic threshold. Of these, 1 million not eligible for subsidies, spent  $3,000 on their prescriptions, with $1,215 being above the catastrophic threshold. This group tended to have serious health conditions, including viral hepatitis, multiple sclerosis, leukemia and lymphoma.



Indeed, as new high-cost drugs enter the pipeline, making prescription drug costs affordable on Medicare  is a priority issue for the Congress.

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