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DCCC Misstates ‘Doughnut Hole’ Effects

The Democratic Congressional Campaign Committee claimed on its website that 8 million seniors pay "full" drug costs when their prescription totals hit the gap in Medicare Part D known as the "doughut hole." But that’s not true; it’s double the actual number. 

The DCCC said: 

DCCC, June 10: Each year about 8 million seniors fall into a gap in Medicare coverage, known as the Medicare donut hole and are forced to pay their drug costs in full out-of pocket.

False. We called Mary Kahn, spokeswoman at the Centers for Medicaid & Medicare Services, to straighten out the figures. She told us about 8 million do reach the gap, but they don’t all have to "pay their drug costs in full" as the DCCC claims. About 4 million of those get low-income subsidies. So, those 4 million don’t feel the gap effects on their wallets. (As we explained in a previous post, most Part D plans pay no benefits once drug expenses reach $2,830 for this year, but coverage picks back up again once the beneficiary’s costs alone reach $4,550.)