Reports: Medicare per-capita costs to go down, doughnut hole entry point lower in 2014

2013 donut hole entry point of $2,970 to decrease to $2,850

NEW YORK — Overall Medicare prescription drug costs will go down in 2014, but the so-called "doughnut hole" coverage gap will get bigger, according to published reports.

Reuters reported that per-capita drug costs for Medicare Part D will drop from this year's $325 to $310 next year, and insurance premiums might go down as well.

Nevertheless, the "donut hole" — a spending threshold when beneficiaries have to pay 50% of their own branded drug costs, before they reach another, higher threshold when the full program coverage for their drugs kicks in again — is likely to be larger. This year, beneficiaries whose drug costs reach $2,970 must pay 50% of the cost, until the cost reaches $4,750. In 2014, those numbers will be $2,850 and $4,550, respectively.

Reuters noted that the point when the donut hole begins isn't related to the Patient Protection and Affordable Care Act, which was designed to help close it; it's the result of a formula related to the per-capita drug costs.


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