The Coverage Gap

The Coverage Gap
Title The Coverage Gap PDF eBook
Author
Publisher
Pages 3
Release 2009
Genre
ISBN

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A unique feature of the Medicare Part D drug benefit is the coverage gap, or so-called "doughnut hole," where Part D enrollees are required to pay 100 percent of total drug costs after their spending exceeds the initial coverage limit and before reaching the catastrophic coverage limit. The coverage gap exists because the cost of providing continuous coverage with no gap exceeded the budgetary limit imposed on the legislation that established the Medicare drug benefit. In 2010, most Part D plans have a coverage gap, which totals $3,610 in drug costs for plans offering the standard Medicare Part D benefit; by 2019, the gap is projected to be nearly $6,000. Part D sponsors are permitted to offer an alternative benefit design that covers at least some drug costs in the gap. Part D enrollees who qualify for the low-income subsidy (LIS) are generally not responsible for costs in the coverage gap. This Part D Data Spotlight examines the coverage gap in Medicare stand-alone Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug (MA-PD) plans, based on the authors' analysis of data from the Centers for Medicare & Medicaid Services (CMS). This research is part of a broader effort analyzing Medicare Part D plans in 2010 and trends since 2006, with key findings summarized in a series of data spotlights.

Frontiers in Health Policy Research

Frontiers in Health Policy Research
Title Frontiers in Health Policy Research PDF eBook
Author David M. Cutler
Publisher MIT Press
Pages 196
Release 2004
Genre Medical care
ISBN 9780262532662

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Leading economists discuss current health policy challenges, including prescription drugs benefits as a component of Medicare and conversion to for-profit health plans.

Medicare For Dummies

Medicare For Dummies
Title Medicare For Dummies PDF eBook
Author Patricia Barry
Publisher John Wiley & Sons
Pages 414
Release 2016-06-02
Genre Business & Economics
ISBN 1119296595

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Medicare For Dummies, 2nd Edition (9781119293392) was previously published as Medicare For Dummies, 2nd Edition (9781119079422). While this version features a new Dummies cover and design, the content is the same as the prior release and should not be considered a new or updated product. Make your way through the Medicare maze with help from For Dummies America's baby boomers are now turning 65 at the rate of about 10,000 a day. Yet very few have any idea about how Medicare works, when they should sign up, or how the program fits in with other health insurance they may have. Medicare For Dummies, 2nd Edition provides a detailed road map for navigating Medicare's often-baffling complexities and helps consumers avoid pitfalls that could otherwise cost them dearly. In plain language, the new edition explains: How to qualify for Medicare, according to your personal circumstances, including new information on the rights of people in same-sex marriages When to sign up at the time that’s right for you, to avoid lifelong late penalties How to weigh Medicare’s many options so you can be confident of making the decision that's best for you What Medicare covers and what you pay, with up-to-date details of the costs of premiums, deductibles, and copays—and how you may be able to reduce those expenses By conveying not only the basics but also how to troubleshoot problems and where to find assistance, Medicare For Dummies, 2nd Edition helps you to get the most out of Medicare.

Care Without Coverage

Care Without Coverage
Title Care Without Coverage PDF eBook
Author Institute of Medicine
Publisher National Academies Press
Pages 213
Release 2002-06-20
Genre Medical
ISBN 0309083435

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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Rare Diseases and Orphan Products

Rare Diseases and Orphan Products
Title Rare Diseases and Orphan Products PDF eBook
Author Institute of Medicine
Publisher National Academies Press
Pages 442
Release 2011-04-03
Genre Medical
ISBN 0309158060

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Rare diseases collectively affect millions of Americans of all ages, but developing drugs and medical devices to prevent, diagnose, and treat these conditions is challenging. The Institute of Medicine (IOM) recommends implementing an integrated national strategy to promote rare diseases research and product development.

Coverage Matters

Coverage Matters
Title Coverage Matters PDF eBook
Author Institute of Medicine
Publisher National Academies Press
Pages 204
Release 2001-10-27
Genre Medical
ISBN 0309076099

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Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

Closing the Coverage Gap

Closing the Coverage Gap
Title Closing the Coverage Gap PDF eBook
Author Robert Holzmann
Publisher World Bank Publications
Pages 246
Release 2009-01-01
Genre Business & Economics
ISBN 0821379801

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This title looks at water availability and water demand in various sectors, estimating the water gap today and through the year 2050. It presents a methodology to prioritise options to bridge the water gap, using the marginal cost of water approach.