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Medicare coverage gap leads to medication noncompliance


WASHINGTON Research indicates that many Medicare patients with chronic conditions stop taking their medications when they have to pay the entire cost of their medications themselves, according to the Associated Press.

About 3.4 million old and disabled Medicare patients encountered a coverage gap called the “doughnut hole” last year, which required them to pay $3,850 for medications themselves before they could start to receive coverage. Under the defined standard Part D benefit package there is a gap in coverage between the initial coverage limit and the catastrophic coverage threshold. Within this gap, the beneficiary pays 100 percent of the cost of prescription drugs before catastrophic coverage kicks in.

Approximately 15 percent of those people stopped taking their medications, including 10 percent of patients with diabetes, 16 percent with high blood pressure and 18 percent with osteoporosis.

The so-called doughnut hole dates back to 2003, when the Republican-led Congress created it to cut federal spending.

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