Five Things To Know About the Bipartisan Budget Act of 2018 and Part D

1. The coverage gap (“donut hole”) closes in 2019 instead of 2020, at which time beneficiaries will have 25% coinsurance requirements for their prescriptions instead of 30%.
2. The manufacturers’ brand-name drugs discount in the coverage gap will increase from 50 to 70 percent beginning in 2019.
3. Biosimilars – previously not included - will be treated the same as other brand-name drugs in the Part D coverage gap, beginning in 2019.
4. The Part B and Part D premium contributions for beneficiaries with modified adjusted gross incomes over $500,000+ for individuals or $750,000+ for couples will increase from 80% to 85%.
5. Eligibility to participate in the Medicare VBID Model for interested plans expanded from three to all states by 2020.

Source: H.R.1892 - Bipartisan Budget Act of 2018
Source URL: https://www.congress.gov/bill/115th-congress/house-bill/1892/

Printer-friendly versionSend to friendmore...