More Medicare Part D
David at The Delaware Right makes a very good point that prior to Part D, there was nothing for many seniors. For them, what we have now is definitely better. He’s right. $2250 in coverage is better than nothing. Amazing how quickly we grow accustomed to "entitlements!" However, I still think the plan is too confusing for mere mortals (especially confused 85-year-olds) to understand.Unfortunately, my parents had better coverage before with their Medigap program and are now in the donut hole, so it's easy to be critical. I was suspicious when their plan announced that they were adopting the Medicare Part D plan. I’m sure it is better for those whose prescription drug use is low, but it’s sure a kicker for those who have several branded meds for which there is no generic.
Here’s what we’re doing: As much as my mom hates to ask for help (and she feels that asking is begging), I’ve convinced her to ask all of my step dad’s doctors for samples of all of his meds. Even if Doctor A didn’t prescribe the drug, he may have samples while the prescribing doc doesn’t. Many of the drug companies have plans were seniors in the donut hole can ask them directly for help, but since they also provide physicians with samples, that’s the easiest way for seniors to meet the need for the next two months.
Labels: donut hole, Medicare Part D
Monday, October 30, 2006
AARP Polls Members re: Medicare Prescription Drug Plan
A new AARP poll indicates that only 46% of Americans age 61 and older think Medicare’s prescription drug plan will be a good thing for older Americans who have difficulty paying for their prescriptions. These older people are even less likely than baby boomers, not yet eligible to participate, to give it a favorable rating. Twenty-six percent of those age 42 and older in this survey think the program is bad for older Americans.This is not surprising as more seniors fall into the donut hole and realize that the Plan is not all it was cracked up to be.
Open season begins November 15. If you are not pleased with your plan, Watch your mail for the Medicare & You handbook and for information from plans in your area. Complete the Rx Enrollment Check-up. You can also review and compare plans on cost and coverage at the Medicare website on the web. This site offers lots of helpful information for seniors. Decide what plan you want for 2007. If you’re satisfied with your current plan, there is no need to re-enroll.
Labels: AARP, donut hole, Medicare Part D
Thursday, October 05, 2006
With an Eye Toward Our Future
As I’ve been consumed this week dealing with the donut hole (and not finding good solutions yet), today there’s news for those of us who are baby boomers. The experience with our parents has probably already taught us that we can’t depend on Medicare and Social Security to cover everything, even though my mom feels that they should. But soon, these concerns will apply to us as well.According to a story from the Wichita Eagle, about the time that three million baby boomers become eligible for Medicare benefits next year, the federal insurance program is proposing to cut payments to physicians by 5.1 percent. This marks another round of proposed decreases in reimbursement rates to doctors, mandated by what physicians call a perpetually flawed formula and once again threatening access to care as fewer doctors say they can afford to see patients with Medicare.
When I worked in health care years ago, both Medicare and Medicaid were blamed for the spiraling costs of health care. Doctors were already limiting their practices to a certain percentage of Medicare patients, and even fewer Medicaid patients. In California, it’s increasingly difficult find doctors who will treat Medicaid patients. Is it likely that by the time we get there, doctors will accept fewer Medicare patients as well? And is it likely that our parents will find it more difficult to find care?
Federal Reserve Chairman Ben Bernanke called for an urgent overhaul of Social Security and Medicare, warning that failure to do so soon could lead to dire economic consequences as the first wave of baby boomers—76 million Americans born between 1946 and 1964—begin taking early retirement in 2008.
Federal lawmakers are unlikely to make the decisions that will solve the problems. As the population ages, fewer workers will be funding our benefits. So it’s important that we begin to look ahead, plan ahead, and be prepared to take responsibility for our own needs. If we depend on the government, we may be sadly disappointed. The biggest problem with the donut hole is that seniors expected the government to take over their prescription drug needs. As the plan is failing, our parents feel betrayed. Let’s make sure we don’t have the same experience.
Labels: donut hole, Medicare Part D, Social Security
Monday, October 02, 2006
The Hole
This week we fell into the hole—the donut hole. We aren’t alone. Three million seniors are expected to fall with us, many this month. The donut hole is a formerly little-known gap in the new Medicare prescription drug plan. Under the plan, the government pays for the bulk of drug costs only until the beneficiary and the government together have spent $2,250 for the year. Then beneficiaries pay 100 percent of costs until they have spent a total of $3,600 of their own money. Only then does the federal government resume its participation, paying 95 percent of any additional expenses. This plan was discussed in a Washington Post article dated last week. The Post estimates that 3 million seniors will fall into the donut hole this year.When the new Medicare Part D Plan went into effect, Dad was in the nursing home. The staff there tried to explain it, but they weren’t sure about the details. And frankly, it was way over my head—and I have a master’s degree in health care administration! Mom didn’t even try. Having no context to understand it, we signed up and prayed for the best. Dad’s prescription drug needs continued to increase and so did his costs. And then, last week when Mom picked up his meds, she was hit with a bill of several hundred dollars!
We’ve been trying to figure out what to do. There are a number of programs that have been developed to help seniors in the hole, but figuring them out is almost as confusing as understanding the Medicare plan. Some of the drug companies have plans to provide their meds at reduced costs, but it looks as if we’ll need to go to several companies. Medicare offers five suggestions for bridging the gap
I’d like to know who our lawmakers thought they were helping. These problems were anticipated when it was in the legislative stage, but no one listened. And now, I’m not the only one feeling smooshed.
Labels: donut hole, Medicare Part D