Medicare beneficiary out-of-pocket cost exposure for Part B drugs and services

Medicare beneficiaries have a variety of coverage options from which to choose, and they may also qualify for supplemental programs or plans that cover additional benefits. Depending on the coverage, beneficiary out-of-pocket (OOP) cost exposure for Part B drugs and services can range from zero for some beneficiaries to unlimited for others. The focus of this paper is on the Medicare population aged 65 and older. This intent of this paper is to:

• Provide a brief overview of Original Medicare and Medicare Advantage (MA) benefits
• Identify the most common secondary or supplemental Medicare coverages and plan designs, and the estimated Medicare membership, monthly premiums, and Part B OOP cost exposure associated with each coverage type 

This report was commissioned by Eli Lilly and Company.