Medicare Part D 2010 Data Spotlight: The Coverage Gap

This data spotlight examines the coverage gap, or “doughnut hole,” in Medicare stand-alone drug plans available in 2010. 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 2010, nearly all the private stand-alone drug plans have a coverage gap, though a small share do provide some help to beneficiaries in the coverage gap, usually covering only generics or a small number of brand-name drugs. One third of those plans with gap coverage charge more for generic drugs in the gap than they do for the same drugs in the initial coverage period.

The spotlight is one in a series analyzing key aspects of the Medicare Part D drug plans that will be available to beneficiaries in 2010. These spotlights were prepared by a team of researchers at Georgetown University, NORC and the Kaiser Family Foundation.

Data Spotlight (.pdf)