More Americans Accessing Improved Medicare Coverage

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services

Millions of Americans are enjoying improved Medicare coverage thanks to the Affordable Care Act. More people are getting preventive services to keep them healthy, and people with high prescription drug costs are seeing the coverage gap “donut hole” starting to close. Here are the latest numbers from the past few months:

  • July:
    • Through the end of July, 1.28 million Americans with Medicare have received discounts on brand name drugs in the Medicare Part D coverage gap — up from 899,000 through the end of June and 478,000 through the end of May.
    • These discounts have saved seniors and people with disabilities a total of$660 million, including $199 million in July alone!

For state-by-state information on the number of people who are benefiting from this discount in 2011, visit this page.

  • August:
    • Through the end of August, over 18.9 million people with Original Medicare, or 55.6 percent, have received one or more free preventive services.
    • During the same time period, over 1.2 million Americans with Original Medicare have taken advantage of Medicare’s new free Annual Wellness Visit, up from 1.06 million in July.

For state-by-state information on the numbers of people who are utilizing preventive services in 2011, visit this page.

Over the coming years, provisions of the Affordable Care Act will help close the coverage gap completely. Here is a sense of what people with Medicare can look forward to:

  • 2013: Paying less and less for your brand-name Part D prescription drugs in the coverage gap.
  • 2020: The coverage gap will be closed, meaning there will be no more “donut hole,” and people with Medicare will pay only 25% of the costs of their drugs until they reach the yearly out-of-pocket spending limit.

The chart below shows what people with Medicare prescription coverage will pay over time:

Medicare Prescription Drug Coverage Over Time

chart showing Medicare Prescription Drug Coverage Over Time

Strengthening Medicare: Halting Cuts to Medicare Payments

By Kathleen Sebelius, Secretary of Health and Human Services

It’s important to protect the high-quality health care currently available to people with Medicare. Unfortunately, the 23% cut in Medicare payments to doctors that is scheduled to go into effect at the end of November has the potential to disrupt the health care that millions of Medicare beneficiaries rely on.

Today, in a speech to the Association of American Medical Colleges, I spoke about why this Administration has made it a priority to ensure this extreme cut in payments to doctors is addressed during the upcoming Congressional session. Here’s an excerpt from my speech:

“…[We] know that health care providers also face significant barriers as you strive to deliver the best care possible. And we’re committed to working with you to reduce them.

That starts with preventing the 23% cut in Medicare payments to doctors that’s scheduled to take effect at the end of the month. These drastic cuts could force doctors out of the Medicare program and jeopardize the care of our seniors.

On Thursday, I attended a Cabinet meeting where the President stressed that preventing these potentially disastrous cuts must be one of our top priorities. The American Medical Association has proposed a 13 month extension. And I hope that Congress will act quickly to pass it, so that our doctors and seniors can have some peace of mind while we work on a long-term fix.

There’s been a lot of talk in the last few months about Medicare and its future. The single biggest step we can take to strengthen Medicare for seniors and disabled Americans is to make sure these disruptive cuts don’t take effect.

As the President has said many times, we will ultimately need a permanent fix, so that the livelihoods of the hard-working doctors who care for seniors and people with disabilities are no longer subject to politics. But in the meantime, we don’t want any doctor to be stuck in a limbo where they don’t know week to week how much they’ll be paid for the services they deliver.

That’s why we’re urging Congress to act now to make sure that you can continue to provide the high quality care our seniors depend on every day.”

Strengthening Medicare is a core value for this Administration. We will continue to act to ensure that the program and the people who receive care and provide care have the resources they need. To learn more about other ways we are working to strengthen Medicare, especially through the Affordable Care Act, click here.