Another Catch-22 in Medicare Part D appears

[RamboLiberal]

http://www.post-gazette.com/pg/06052/658671.stm

For potentially thousands of lower-income Medicare recipients, the benefit of free drugs from pharmaceutical companies is suddenly becoming a burden.

If they decide to stay with the free drugs and not enroll in the new Medicare Part D drug program by May 15, they'll have to pay an increasingly large penalty to get in later should their medical needs or the pharmaceutical companies' programs change.

The Catch-22 situation is another example of how the new benefit, which promises help to people who previously lacked drug coverage, has created confusing or difficult decisions for beneficiaries already receiving some sort of pharmacy benefit.

As seniors have immersed themselves in the details of the Part D plan, a growing number have become frustrated by these nettlesome issues. A new nationwide poll released last week by the nonpartisan health policy group Kaiser Family Foundation found retirees were almost twice as likely to say they viewed the benefit unfavorably as favorably.

[rodeodance]

1. built in punishments for the people and profits for the drug companies--

all part of our new america.

[rodeodance]

2. same with NCLB--profits for book/testing industries-punishments to

school districts.

[ArbustoBuster]

19. Privatizing profits, socializing risk.

It's the Republican way!

[Up2Late]

3. This program was NEVER meant to help the poor and mid-income...

...people, the so-called "donut-hole" is evidence of that. If the media truly is just waking up to this fact, they truly are stupid. :crazy:

[Felix Mala]

4. "Bad! Bad poor people! Punishment will continue until you stop being poor.

[Mithras61]

5. Heck, anyone that was payin attention when they passed this knows...

that the "Prescription Drug Benefit" is only a benefit for the pharmceutical industry. I guess the MSM is just now catching up to those of us here who WERE paying attention...

[zanne]

6. We're being punished, alright.

I'm one of those low-income people on Medicare who was receiving free prescription drugs for two years. I take nine prescriptions daily. I just received letters from two of the drug companies saying that they would no longer be participating in the free prescription programs because of Medicare Part D. The three drugs they used to give me for free are the most expensive, (all cardiac drugs). The other two pharmaceutical companies that provide me with free meds are uncertain about what they're going to do. So I'm sitting between a rock and a hard place. It would cost me more to sign up for Medicare Part D today, as things stand, but I don't know whether or not those pharm. companies that are still giving me free drugs will continue to do so, and if I don't sign up now, I'll be penalized. Either way, I'm worse off than I was before this new program.

[aquart]

7. Even if you sign up, the drug companies can desert at any time.

If you are prescribed a new drug......good luck.

Worst bill ever passed. AND OUR CONGRESSMEN KNEW IT. They voted against this horrific bill. And DeLay and Hastert kept the voting open.

We know about DeLay. What did Hastert get for betraying his countrymen?

[bluerum]

8. This is a phased in medical extortion plan.

"If they decide to stay with the free drugs and not enroll in the new Medicare Part D drug program by May 15, they'll have to pay an increasingly large penalty to get in later should their medical needs or the pharmaceutical companies' programs change."

Confusing and difficult decision alright. Why should they be penalized at all for making a decision that saves them money?

It is a reality that medical needs change. Why can't a health care/drug plan/ insurance program simply recognize that up front instead of saying "should their medical needs change" as if there is some question about it.

What are the chances that the pharmaceutical companies will not change their programs? I would say between 100% and 100% certainty on that one.

This is a phased in medical extortion plan.

on edit: darned spell checker.

[OneBlueSky]

9. most drug companies -- perhaps all -- are simply removing people . . .

who are eligible for Part D from their patient assistance programs . . . whether you actually sign up for Part D is irrelevant . . . and whether the insurers offering Part D plans will actually pay for the drug you need is also irrelevant . . . a lot of people are getting royally screwed, and I'm one of 'em . . .

[SoCalDem]

10. and technically EVERYONE qualifies.. how convenient.

This way the pharma companies can get a graceful exit from the freebie drugs plan they used to offer to people who could not afford their meds.. They can say "Hey, we HAD to cancel the plan because NOW they have a plan to fall back on, and they don;t need us anymore"..

[Flirtus]

11. Empoyers (like me) with very nice coverage for employees

also have a new set of forms to submit information on "employees covered by Part D and private insurance" Guess what, we don't have anyone who qualifies for Part D and I'm having a hard time keeping up with the new paperwork which has to be sent in anyway and so I'm in trouble for ignoring it for three months.

Not that my rant has anything to do with the OP, but it's a lot of information gathering by a new agency.

[underpants]

14. Welcome to DU

:hi:

If you don't mind I might try to pick your brain on some small business questions.

[oneold1-4u]

12. Choices?

Since I only pay for one Rx at this time for tummy and the cost of any plan would only save a few dollars for a few months, I "choose" not to play this stupid, confusing, money grabbing hullabaloo until it is changed to make some sense! A ton of tums may have to be the choice when they start putting people in jail for non-compliance and it seems "*" will have his way!

[superconnected]

13. Gee, the seniors as a majority voted for bush.

Sad for them that they can't get life sustaining drugs now, but really, for all of them that went bush, DUMBASSES, you're literally killing everyone else, with you.

[Richard Steele]

15. Just the NeoCon agenda in action; nothing to see here!

[Samurai_Writer]

16. I was just talking about this with my mom this weekend.

I went to visit her this weekend. She cares for my sister, who is totally disabled due to schitzophrenia. ONE of my sister's medications cost $800 a month. She used to get them for free from the drug company under their charity program, but they are discontinuing it because of Part D. It is an experimental drug and probably not covered under Part D. It's so confusing, my mom cannot figure it out. Plus, my sister is on several other drugs for her mental illness and also diabetes. But not one of the Part D plans covers everything. My sister gets $1000 a month in SSDI, so she will basically be paying over that per month for her drugs now. My mom, thank goodness, has her own private health plan with drug coverage. It's $250 a month, but she is not going on Medicare because she is afraid her prescriptions won't be covered.

My other siblings and I are going to have to start helping to pay for my sister's meds and also giving my mom some money each month for living expenses. What about people who don't have families or friends who can help them? The whole thing makes me sick.

[knitter4democracy]

17. That's so bad.

My hubby, an internist, has so many patients in that situation that he can't even talk about it. He's just fuming. There's nothing worse than seeing Pharma's profits go through the roof while patients suffer.

[TexasLawyer]

18. Just Wait 'til People Start Hitting the Doughnut Hole!

By the November elections there will be some VERY pissed off people, who won't have read the fine print.


The Deadly Doughnut
By Paul Krugman
The New York Times

Friday 11 November 2005

<snip>
Before we turn to the larger issue, let's look at how the Medicare drug benefit will work over the course of next year. At first, the benefit will look like a normal insurance plan, with a deductible and co-payments.

But if your cumulative drug expenses reach $2,250, a very strange thing will happen: you'll suddenly be on your own. The Medicare benefit won't kick in again unless your costs reach $5,100. This gap in coverage has come to be known as the "doughnut hole." (Did you think I was talking about Krispy Kremes?)

One way to see the bizarre effect of this hole is to notice that if you are a retiree and spend $2,000 on drugs next year, Medicare will cover 66 percent of your expenses. But if you spend $5,000 - which means that you're much more likely to need help paying those expenses - Medicare will cover only 30 percent of your bills.

A study in the July/August issue of Health Affairs points out that this will place many retirees on a financial "roller coaster." People with high drug costs will have relatively low out-of-pocket expenses for part of the year - say, until next summer. Then, suddenly, they'll enter the doughnut hole, and their personal expenses will soar. And because the same people tend to have high drug costs year after year, the roller-coaster ride will repeat in 2007.

<snip>

http://www.truthout.org/docs_2005/111105K.shtml