Icon WebMD Expert Blogs

Health Reform 101

with Lisa Zamosky

WebMD helps readers understand their health insurance and the new health care reform law. The Affordable Care Act is bringing sweeping changes to American health care. Lisa Zamosky is here to help you navigate the health care maze and understand how these changes affect you.


The opinions expressed in WebMD User-generated content areas like communities, review, ratings, or blogs are solely those of the User, who may or may not have... Expand

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.

Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.


Thursday, February 9, 2012

‘Donut Hole’ Savings for Seniors

By Lisa Zamosky

Donut Hole

In a rare piece of good news about the cost of health care, the Obama administration announced last week that in 2011, 3.6 million seniors on Medicare saved $2.1 billion on prescription drug costs.

The savings are the result of a provision of the health reform law which will steadily shrink and ultimately eliminate the gap in Medicare Part D prescription drug coverage known as the donut hole. Seniors who hit the donut hole last year saved an average of $604.

The Law’s Benefits

This year, if you enter the donut hole you’ll receive a 50% discount on covered brand-name drugs and a 14% discount on covered generics. The gap in drug coverage begins once you reach your Medicare Part D plan’s initial coverage limit, which in 2012 is $2,930. It ends when you spend a total of $4,700. Prior to the law taking effect, if you entered the donut hole, you paid full price for your medication.

Additional Savings

Last week, the government also announced that between 2011 and 2021 Medicare savings should total about $4,200 per person.

Part of that savings comes from the availability of preventive health services with no cost sharing. Last year, Medicare began covering the full cost of certain types of preventive care, such as annual wellness visits, cholesterol and other cardiovascular screenings, as well as cancer screenings such as mammography and colonoscopies. Seniors no longer pay annual deductibles, co-pays, or coinsurance for these services.

And starting at the beginning of this year, if you have Medicare coverage, there are five new health screenings the Centers for Medicare and Medicaid Services (CMS) added to its list of free services. These include:

  • Annual depression screening
  • Obesity screening and behavioral counseling
  • Annual cardiovascular screening
  • Annual alcohol misuse screening
  • Sexually transmitted disease and infection screening (for people that have certain risk factors)

You can see the full list of preventive services covered at

Share your experience: Have you seen your health care costs reduced as a result of doughnut hole discounts and free preventive care? Share your experience in the comments section below.

Click here to return to our coverage of the Supreme Court hearings

Posted by: Lisa Zamosky at 1:53 pm


Leave a comment

Subscribe & Stay Informed

WebMD Daily

Get your daily dose of healthy living, diet, exercise and health news from WebMD!


WebMD Health News