The Act makes several improvements to Medicare including:
- Provides a $250 rebate to Medicare beneficiaries who reach the Part D coverage gap in 2010 (Effective January 1, 2010);
- Phases down gradually the beneficiary coinsurance rate in the Medicare Part D coverage gap from 100% to 25% by 2020;
- For brand-name drugs, require pharmaceutical manufacturers to provide a 50% discount on prescriptions filled in the Medicare Part D coverage gap beginning in 2011, in addition to federal subsidies of 25% of the brand-name drug cost by 2020 (phased in beginning in 2013);
- For generic drugs, provide federal subsidies of 75% of the generic drug cost by 2020 for prescriptions filled in the Medicare Part D coverage gap (phased in beginning in 2011);
- Between 2014 and 2019, reduce the out-of-pocket amount that qualifies an enrollee for catastrophic coverage.
On the other hand, changes to the provider reimbursement levels and MedicareAdvantage programs could reduce access to providers or coverage options forMedicare beneficiaries.