Seniors Pay High Price for Gap in Benefits Coverage
byon 07-04-2012 at 01:43 PM (171 Views)
"Given that the Medicare Part D drug benefit was unveiled, it has confirmed to be even far more confusing and inefficient than its critics predicted. Even seniors who have been able to register for the plan should nevertheless struggle with a $3,000 gap in benefits coverage and a hefty monthly premium.
Already the government has had to modify the plan: The Centers for Medicaid and Medicare Solutions reversed an earlier decision prohibiting new Medicare prescription drug plan recipients from participating in free or subsidized drug applications sponsored by pharmaceutical manufacturers.
But we can not stop there. The reversal fails to count the full value of these prescriptions toward seniors $3,000 obligation, an expense that could place numerous 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 expenses over $two,000 till catastrophic coverage kicks in at $5,100.
We can and must close the holes that might ruin seniors fiscal wellness as they try to preserve their physical wellness.
Private businesses are already taking action. A group of pharmaceutical businesses announced a strategy referred to as "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 must also act by letting those who qualify for subsidized pharmaceutical manufacturer programs like Bridge Rx - but who concurrently pay a monthly Element D premium - count the full value of their medications formulary cost toward the $3,000 gap.
The purpose of the Medicare prescription drug system was to help seniors, not produce revenue for insurers and pharmacy benefit managers. Its time to deliver on the promises that had been made. medical fraud"