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Closing Gap for Medicare Coverage

It was announced this weekend that House Speaker Nancy Pelosi hopes to pass a healthcare reform bill that will close the gap in Medicare drug coverage. Currently, Medicare beneficiaries face a “doughnut hole” gap in coverage after the first $2,700 is spent on drug coverage and continues until medication expenses reach $6,154.

According to Pelosi, the new healthcare bill will help to close this gap by lowering the cost of prescription drugs for approximately 4 million Medicare beneficiaries. “As of January 1, 2010, our legislation will give a 50 percent discount for brand-name drugs to recipients in the doughnut hole, and it will reduce the size of the doughnut hole by $500,” said Pelosi.

Currently, millions of Americans enrolled in Medicare programs require Medicare Supplemental insurance to help cover the cost of uncovered medical expenses. Medicare Supplemental insurance may help to reduce the cost of thousands of dollars of doughnut hole expenses that some Medicare beneficiaries have to pay.

The new bill builds upon the intentions of the previous bill, which intended to close the gap by January of 2011. The new bill will also close the gap in coverage for prescription medications within 10 years, whereas the previous bill would have required 15 years to close the prescription medication gap.

The new bill was amended in response to wavering support by the elderly population. According to the AARP, the doughnut hole gap has been a top concern amongst the critical elderly population. Such changes to the doughnut hole gap could result in increased support of the bill.

If the new bill passes, many Medicare beneficiaries will have to pay less for their medications, but it is still unclear exactly who will be covered by the changes and what the exact costs of those changes may be for consumers. In the meantime, it is wise for Medicare beneficiaries to enroll in Medicare Supplemental insurance programs that will help to cover their uncovered medical expenses.

Any changes to Medicare plans, including the addition of Medicare Supplement insurance plans, need to be made during the upcoming Medicare Open Enrollment period, which is from November 15 to December 31, 2009.

Are you looking for information about Medicare Supplement programs that may help you pay for your healthcare more easily? For help finding the best Medigap plan for your situation, contact Medigap Advisors at 866-323-1441.

Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage. For more information visit


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