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Most Will Avoid Medicare Rx Gap, AHIP Says

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Around 3 million seniors will reach the Medicare Part D coverage gap, but most seniors will avoid it, according to America’s Health Insurance Plans.

AHIP, Washington, estimates that health insurance plans’ cost-containment strategies will lower beneficiaries’ out-of-pocket costs to the point where they would not exhaust policy limits on prescription costs for most seniors.

Based on actual health insurance plan data, AHIP estimates about 10% of Medicare Part D beneficiaries have reached the gap to date.

Beneficiaries are taking advantage of negotiated drug prices, increased use of generic drugs when appropriate, step therapy and disease management programs, and mail-order services to avoid or delay the coverage gap, Karen Ignani, president and CEO of AHIP, says.


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