1.
Generic Drugs Brand-Name Drugs
Plan Year Bene Pays
(Counts Toward
TrOOP)
Plan Pays Bene Pays
(Counts Toward
TrOOP)
Plan Pays Drug
Manuf.
Discount
(Counts Toward
TrOOP)
Amount
that
Counts
Toward
TrOOP
2006 -
2010
100% 0% 100% 0% 0% 100%
2011 93% 7% 50% 0% 50% 100%
2012 86% 14% 50% 0% 50% 100%
2013 79% 21% 47.5% 2.5% 50% 97.5%
2014 72% 28% 47.5% 2.5% 50% 97.5%
2015 65% 35% 45% 5% 50% 95%
2016 58% 42% 45% 5% 50% 95%
2017 51% 49% 40% 10% 50% 90%
2018 44% 56% 35% 15% 50% 85%
2019 37% 63% 30% 25% 20% 5% 50% 70% 80%95%
2020 -
beyond
25% 75% 25% 25% 5% 50% 70% 75% 95%
Medicare Part D Prescription Drug Plan Coverage Gap Discount
Under the BBA of 2018
1

2.
2
Current Law
2019
Standard Part
D Benefit
FY 2019
Budget
(published
prior to BBA-
2018
Enactment)
Standard Part
D Benefit
Deductible
($415)
Beneficiary 100% 25%
Plan
Manufacturer
Federal Government
Beneficiary 100% 25%
Plan
Manufacturer
Federal Government
Deductible
($415)
Beneficiary 100% 25%
Plan
Manufacturer
Federal Government
Beneficiary 100% 25%
Plan
Manufacturer
Federal Government
50%
25% 80%
80%
Generic
37%
75% 63%
Initial Coverage
Period
($3,820 in total drug costs)
Coverage Gap
(Donut Hole)
($5,100 in out-of-pocket costs)
Catastrophic
Phase
25%
Brand
75%
Generic
37%
75% 63%
80%
Brand
25%
75%
70%
80%
Initial Coverage
Period
($3,820 in total drug costs)
Coverage Gap
(Donut Hole)
($5,100 in out-of-pocket costs)
Catastrophic
Phase
5%
15%5%
20%
20%
0%
0%
5%
15%