News Headlines Article

Doughnut Hole Is Gone, But Medicare’s Uncapped Drug Costs Still Bite Into Budgets
Kaiser Health News

Three times a week, Tod Gervich injects himself with Copaxone, a prescription drug that can reduce the frequency of relapses in people who have some forms of multiple sclerosis. After more than 20 years with the disease, Gervich, 66, is accustomed to managing his condition. What he can’t get used to is how Medicare’s coinsurance charges drain his wallet.

Unlike commercial plans that cap members’ out-of-pocket drug spending annually, Medicare has no limit for prescription medications in Part D, its drug benefit. With the cost of specialty drugs increasing, some Medicare beneficiaries could owe thousands of dollars in out-of-pocket drug costs every year for a single drug.