Seniors Pay High Price For Gap In Benefits Coverage

Seniors Pay High Price For Gap In Benefits Coverage



Since the Medicare Part D drug benefit was unveiled, it​ has proven to​ be even more confusing and​ inefficient than its critics predicted. Even seniors who have been able to​ register for​ the program must still struggle with a​ $3,000 gap in​ benefits coverage and​ a​ hefty monthly premium.

Already the government has had to​ change the program: The Centers for​ Medicaid and​ Medicare Services reversed an​ earlier decision​ prohibiting new Medicare prescription​ drug plan recipients from participating in​ free or​ subsidized drug programs sponsored by pharmaceutical manufacturers.

But we can't stop there. The reversal fails to​ count the full value of​ these prescriptions toward seniors' $3,000 obligation, an​ expense that could put many in​ the poorhouse.

The Bush administration​ claims that its new benefit is​ a​ good deal for​ people who are not eligible for​ Medicaid. Yet most individuals will pay not only a​ $250 deductible, but also 25 percent co-insurance on​ the next $2,000 in​ covered drug costs. and​ add roughly $32 a​ month per person​ for​ a​ monthly premium.

in​ addition, the new Medicare plan requires each senior to​ cover 100 percent of​ the costs over $2,000 until catastrophic coverage kicks in​ at​ $5,100.

We can and​ must close the holes that may ruin​ seniors' fiscal health as​ they try to​ preserve their physical health.

Private companies are already taking action. a​ group of​ pharmaceutical companies announced a​ plan called "Bridge Rx," which will help seniors trapped in​ the $3,000 hole afford their medications. Seniors will get drug discounts of​ at​ least 50 percent in​ exchange for​ a​ 15 percent co-pay.

Washington​ should also act by letting those who qualify for​ subsidized pharmaceutical manufacturer programs like Bridge Rx - but who concurrently pay a​ monthly Part D premium - count the full value of​ their medications' formulary price toward the $3,000 gap.

The purpose of​ the Medicare prescription​ drug program was to​ help seniors, not generate revenue for​ insurers and​ pharmacy benefit managers. It's time to​ deliver on​ the promises that were made.




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