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Medicare Rx “donut hole” coverage demo

Executive Summary

Medicare Part D supplemental drug coverage demonstration project allowing drug plans to cover the "donut hole" is announced in Feb. 25 1Federal Register notice. Prescription drug plans offering enhanced alternative coverage would receive a capitated drug reinsurance payment instead of specific reinsurance payments of 80% of drug costs after a beneficiary has reached the catastrophic coverage level. The plan may fill the "donut hole" in part or in its entirety and must provide catastrophic drug coverage. Medicare Advantage drug plans may choose to fill the coverage gap using Part A or Part B rebate dollars. Health insurers worked with the Centers for Medicare & Medicaid Services to have the demo project developed (2"The Pink Sheet" Jan. 24, 2005, p. 14)...

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