While the Obama administration trumpets the new health care provision that eventually will close the much-maligned “doughnut hole” gap in Medicare prescription drug coverage, it rarely mentions another piece of the law which, this year, requires affluent Medicare beneficiaries to pay more for prescription drugs.

In 2007, high-income Medicare beneficiaries were charged more on a sliding scale for Medicare Part B premiums. The health care law expanded this means-testing feature to Medicare Part D, with the change going into effect in January. Worse still for high earners, the law freezes the income thresholds through 2019, which means that thanks to inflation, more and more seniors will fall into this category.

For 2011, the standard Medicare Part B monthly premium comes in at $115.40, while high earners will pay anywhere from $161.50 to $369.10. Because Part D premiums vary depending on coverage, high earners will pay between $44 and $101 with the national average being $32.34 (according to the Kaiser Family Foundation).

Some critics of means-testing worry that wealthier Medicare beneficiaries might decide to leave the program for private insurance, which would drive up costs for those left behind as wealthier seniors tend to be healthier.

According to the Centers for Medicare and Medicaid Services, in 2011 some 1.7 million seniors will pay the higher premium for Medicare Part B coverage, while 822,000 will pay more for Part D.
By 2019, nearly 20 percent of first-time Part B enrollees will pay higher premiums for Part B due to income.