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The Health Care Law & You

Closing the Medicare Part D Coverage Gap

What happens, when

En español l The health care law adds benefits to help make your Medicare prescription drug coverage more affordable. If you reach the Medicare Part D coverage gap, you can get discounts on your prescription drugs. The discounts will gradually increase until the coverage gap disappears in 2020.

Here’s how it works:

  • 2013: You’ll get a 52.5 percent discount on brand-name and a 21 percent discount on generic drugs.
  • 2014: You’ll get a 52.5 percent discount on brand-name and a 28 percent discount on generic drugs.
  • 2015: You’ll get a 55 percent discount on brand-name and a 35 percent discount on generic drugs.
  • 2016: You’ll get a 55 percent discount on brand-name and a 42 percent discount on generic drugs.
  • 2017: You’ll get a 60 percent discount on brand-name and a 49 percent discount on generic drugs.
  • 2018: You’ll get a 65 percent discount on brand-name and a 56 percent discount on generic drugs.
  • 2019: You’ll get a 70 percent discount on brand-name and a 63 percent discount on generic drugs.
  • 2020: The Medicare Part D coverage gap is closed.

How much you’ll pay out of pocket for each drug may vary depending on your Part D plan, the prices your plan negotiated and how it has structured its gap coverage.

Updated August 2013

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