PUP 4931r Lecture Notes - Lecture 67: Generic Drug, Prescription Drug, Co-Insurance
Medicare Use, Physician Participation
Spending by Age Group: most use between 65-79 years; 30% of use population
Most office based physicians accept new Medicare patients; rates for Medicare
are the same/better than private insurance
Majority of medicare beneficiaries report having a usual source of care—typically
a doc office visit
Most can schedule timely appointments
Medicare Revenues, Plans
Financing: Primarily financed by payroll taxes
Medicare Part A (HI) Financing and Tax Rate:
Financing: Primarily finance by payroll taxes
Tax rate paid by employee: 1.45%
Tax rate paid by employer: 1.45%
Total tax rate paid by both employer-employee: 2.90%
Total tax rate paid by self-employed: 2.90%
High Income workers will pay an additional 0.9 percent of their earnings above
$200,000 (for those who file an individual return) or $250,000 (for those who file
a joint income tax return)
Annual deductible
$320*
Co-insurance:
25% of drug costs between $320 and $2,960*:
Coverage gap:
65% out-of-pocket spending for generic drug costs between
$2,960~$4,700*. A 55% discount is available on covered brand-name
prescription drugs at the time of purchase.
Extra help:
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Spending by age group: most use between 65-79 years; 30% of use population. Most office based physicians accept new medicare patients; rates for medicare are the same/better than private insurance. Majority of medicare beneficiaries report having a usual source of care typically a doc office visit. Medicare part a (hi) financing and tax rate: Total tax rate paid by both employer-employee: 2. 90% High income workers will pay an additional 0. 9 percent of their earnings above. ,000 (for those who file an individual return) or ,000 (for those who file a joint income tax return) 25% of drug costs between and ,960*: 65% out-of-pocket spending for generic drug costs between. A 55% discount is available on covered brand-name prescription drugs at the time of purchase. Benefit for people with income less than ,505 for an individual (,595 for a married couple living together). Note: individual state might apply different criteria for extra help.