How will the PPACA affect Medicare eligible employee coverage?
Medicare eligible employees are affected by PPACA as follows:
• Provides a $250 rebate to those who reach the Part D coverage gap in 2010.
• Phases down to 25% by 2020 the beneficiary coinsurance rate in the Part D coverage gap.
• For brand-name drugs, requires drug makers to provide a 50% discount on Part D prescriptions filled in the Part D coverage gap, in addition to federal subsidies of 25% of brand-name drug cost by 2020.
• For generics, provides federal subsidies of 75% of the generic drug cost by 2020 for prescriptions filled in the Part D coverage gap.
• Reduces, between 2014 and 2019, the out-of-pocket amount that qualifies an enrollee for catastrophic coverage.
• Possible reduction in access to providers or coverage options because of changes to provider reimbursement levels.