Medicare Part D 2009 Data Spotlight: The Coverage Gap

This Medicare Part D data spotlight examines the coverage gap, or “doughnut hole,” in Medicare drug plans available in 2009. While in the gap in coverage, Part D enrollees (other than those receiving low-income subsidies) are required to pay 100 percent of total drug costs until they reach the catastrophic coverage level.

In 2009, nearly all Part D plans have a coverage gap, though one in four plans offer limited coverage in the gap — generally coverage for all or some generic drugs, though some plans also cover some or a few brand-name drugs.

The spotlight is one in a series analyzing key aspects of the Medicare Part D drug plans that will be available to beneficiaries in 2009. The analysis was conducted jointed by Jack Hoadley and Jennifer Thompson of Georgetown University, Elizabeth Hargrave of NORC at the University of Chicago, and Juliette Cubanski and Tricia Neuman of the Kaiser Family Foundation.

Data Spotlight (.pdf)