Costs in the Medicare Part D coverage gap
The Medicare Part D coverage gap is the temporary limit on what your Medicare Part D Prescription Drug Plan pays for prescription drugs. Beneficiaries enter the coverage gap once they and their plans have spent a certain combined amount on covered drugs. While beneficiaries were previously responsible for 100% of prescription drug costs in the coverage gap, the Affordable Care Act reduces these costs through manufacturer discounts and government subsidies. Beneficiaries who enter the coverage gap will be responsible for a smaller portion of covered drug costs every year until the coverage gap, also known as the donut hole, is closed in 2020.
Medicare preventive services
The Affordable Care Act also expands Medicare preventive benefits. Certain services may now be completely covered for Medicare beneficiaries; this includes, but isn’t limited to:
Abdominal aortic aneurysm screenings
Alcohol misuse screenings and counseling
Cardiovascular disease screenings
Cervical and vaginal cancer screenings
Certain colorectal cancer screenings
HIV screenings
Depression screenings
Diabetes type 2 screenings
Nutrition counseling services
Obesity screenings and counseling
Certain vaccines, such as the flu shot, pneumococcal shot, and hepatitis B shot
Sexually transmitted infections screenings and counseling
One-time ‘Welcome to Medicare’ preventive visit
Annual ‘Wellness’ visits