Friday, April 28, 2006

Doughnut Hole

Mildred Lindley is stuck in a hole, the doughnut hole -- "right in the middle of it," she says -- that comes with Medicare's new prescription drug benefit.

Just four months into the program, Lindley has hit the point in her coverage where she has to pick up, at least for a few months, the full cost of the medication she takes to keep her bone marrow cancer in remission. As a result, her two-month supply of Thalomid shot up from $40 to a whopping $1,300.

One of the “side effects” of Medicare Part D prescription drug coverage.

"If I can't get it, I guess I'm here until the Lord takes me out. That's all I can do, because there's no way I can afford it," said Lindley, an 80-year-old from Jonesboro, Arkansas.

"I'm in the hole all right."

At least she has a sense of humor about it, but this is no laughing matter.

Under the standard drug benefit, the government subsidizes the drug costs for seniors and the disabled. But after costs reach $2,250, the subsidy stops until a beneficiary has paid out $3,600 of his or her own money. Then, the government will start picking up 95 percent of each purchase.

This is one of those can’t win situations. Before Part D there was no drug coverage.
After Part D this can happen . . .

However, there are beneficiaries who are convinced they will be worse off, many of whom had relied on free medicine provided by the drug manufacturers. They were told by the manufacturers this year that the free supplies would stop now that they were eligible for Medicare coverage.

Prescription assistance plans may go the way of the buggy whip.

Or maybe not?

A new opinion from the Inspector General of DHS gave approval to drug manufacturers to supply free medicine to low-income individuals who are not only eligible for Part D but also enrolled in a Medicare drug plan.

Either way, this is just another example of government meddling in something that is now worse than it was before.
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