The coverage gap begins after you and your drug plan have spent a certain amount for covered drugs. Next year the gap starts at $2,960 (up from $2,850 this year) and ends after you’ve spent $4,700 (up from $4,550 this year).
Seniors who enter the gap also get discounts on brand-name and generic drugs, and those breaks will be larger next year. Enrollees will pay 45 percent of the cost of brand-name drugs in 2015 (down from 47.5 percent this year) and 65 percent of the cost of generic drugs (down from 72 percent this year).
Can the recent good news on lower healthcare costs continue indefinitely? Medicare spending reflects our overall health economy, and the big picture is that the United States does not have effective controls on spending growth.
Healthcare outlays have quadrupled since the 1950s as a percentage of gross domestic product, to 17.7 percent in 2011. What's more, our spending is more than double any other major industrialized nation, according to the Organization for Economic Cooperation and Development.
Still, our per capita Medicare spending growth averaged 2 percent from 2009 to 2012 - and it was nearly zero last year.
The Obama administration often points to the ACA, but outside experts are more skeptical. Research published this month by Health Affairs, a leading health policy and research and journal, credited 70 percent of the recent spending slowdown to the slack economy. Absent further changes in the structure of our healthcare system, the researchers expect higher healthcare inflation to resume as the economy improves.
“A significant amount of it is due to the economic slowdown,” says Eyles, "although we know that changes in the way providers deliver care, and how providers are being paid are also making a difference in the overall rate of growth.”
The writer is a Reuters columnist. The opinions expressed are his own.