Riding the rollercoaster: the ups and downs in out-of-pocket spending under the standard Medicare drug benefit

UMMS Affiliation

Department of Medicine, Division of Geriatric Medicine; Meyers Primary Care Institute

Publication Date


Document Type



*Actuarial Analysis; Aged; Aged, 80 and over; Chronic Disease; Female; Financing, Personal; Health Expenditures; Health Maintenance Organizations; Humans; Insurance, Pharmaceutical Services; Male; Marital Status; Medicare; Poverty; United States


Health Services Research | Primary Care


This study projects how much Medicare beneficiaries who sign up for the standard Part D drug benefit in 2006 will pay in quarterly out-of-pocket payments through 2008. In the first year we estimate that about 38 percent of enrollees will hit the benefit's no-coverage zone, known as the "doughnut hole," and that 14 percent will exceed the catastrophic threshold. Because drug spending is highly persistent over time, beneficiaries who experience the biggest gaps in coverage are likely to do so year after year, with potentially serious financial consequences.

DOI of Published Version



Health Aff (Millwood). 2005 Jul-Aug;24(4):1022-31. Link to article on publisher's site

Journal/Book/Conference Title

Health affairs (Project Hope) 16284055

Related Resources

Link to Article in PubMed

PubMed ID