Medicare's Prescription Donut Hole Imposes Hardship on America's Elderly: Two Alternatives Emerge

March 11, 2009 - PRLog -- Many of the 40 million Americans on Medicare are finding it increasingly difficult in this sour economy to meet their needs for prescription medications due to the requirement to pay over $4,000 out-of-pocket under Medicare's Part D drug benefit.

  Medicare's Part D prescription drug benefit, enacted in 2006, leaves a huge coverage gap, known as the donut hole, that leaves beneficiaries responsible for 100% of the cost of their prescription medications.   Part D coverage is available through a number of private insurers.   In 2009, beneficiaries pay the first $295 of their prescriptions-the deductible, then 25% of the cost of their medicine until the total out-of-pocket reaches $2,700. Thereafter they are responsible for 100% of the cost of their medications until the total out-of-pocket reaches $4,350.  Once this limit is reached, the beneficiary is in the 'catastrophic' phase and Medicare covers most -approximately 95%- of the cost of medications.   This burden can be mitigated somewhat by purchasing a Medicare supplement or enrolling in a Medicare Advantage plan many of which include Part D coverage.  Such plans, available from private insurers, contain formularies that typically rank medications in tiers for the purpose of determining co-payments.

  Recently developed are two alternatives to this burdensome expense.  Comprehensive prescription discount programs can slash the cost of medications preventing Medicare beneficiaries from ever reaching the dreaded donut hole.  These are often available from individual pharmacy chains and are designed as much to encourage customer loyalty as they are to offer price breaks to financially strapped seniors - and others affected by the recession.  There are, however, a few programs that are accepted by multiple pharmacy networks...and bring real value when a customer does not always shop in the same place.  Second is a program whereby pharmaceutical companies will offer medications to lower income people practically for free.  Third party companies will typically verify eligibility and submit documentation to the companies manufacturing the needed medications.  Under this program, out-of-pocket expense can often be capped at under $100 a month for generics and brand name medications alike.

  For further information on either program visit http://tr.im/meds .  If you would like to offer these programs visit http://jshous.mysmilepays.com

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