May 6, 2021 Breaking News, Latest News, and Videos

Closing The Medicare Part D Program Doughnut Hole: The End Is In Sight!:

By Ron Pollack – Families USA Executive Director

The meaning of the 2012 election results will probably be debated for months, if not years. But a few things are clear: nearly everyone agrees that President Obama’s reelection means that the Affordable Care Act – the 2010 health care law sometimes called Obamacare – will stay in place. And for people with Medicare Part D prescription drug coverage, especially those who use a lot of prescription drugs, that’s good news.

When the Medicare prescription drug program (Part D) was created in 2003, it included a large gap in coverage that’s known as the “doughnut hole.” After beneficiaries reached an “initial limit” of total drug expenses ($2,930 in 2012), they had no prescription drug coverage until they got to the other side of the doughnut hole – by spending $3,700 more out of their own pockets – and reached the “catastrophic limit” for the year.

The doughnut hole meant that nearly four million beneficiaries with significant prescription drug costs – the people who need help the most – had to pay the full cost for their medications for months at a time. Many had to choose between buying their medications and buying groceries. Others resorted to skipping doses or splitting pills. What’s more, the problem was going to get worse: The gap was going to grow to more than $6,000 by the year 2020.

The doughnut hole never made any sense as a matter of health insurance. Why would coverage stop when you needed it the most? But until the health care law was passed, nobody had done anything about it. Now, the doughnut hole is being gradually filled in. In 2012, people who entered the gap received a 50 percent discount on name-brand drugs and a 14 percent discount on generics. In 2013, those discounts increase to 52.5 percent on name-brand drugs and 21 percent on generics. The discounts will increase each year until 2020, when the gap will be completely filled.

This change is making a positive difference in people’s lives. According to the agency that runs Medicare, since the law took effect, about 5.8 million people with Medicare have gotten help with their drug costs. The total value of the help is now $5.1 billion. That’s money that’s stayed in seniors’ pockets rather than being spent at the pharmacy. As of the end of October 2012, the average savings has been $677 a person. That’s a lot of groceries – or presents for the grandkids.

There’s also some encouraging research confirming what a lot of us intuitively sense: that making prescription drugs more affordable saves money down the road by keeping people healthier. When people with diabetes get their insulin regularly, for example, they’re more likely to stay out of the hospital. Of course this is great for them; no one likes going to the hospital. But it’s good for all of us, because hospital care is expensive, and keeping people healthy and out of the hospital is one of the most obvious ways of bringing health care costs under control. Recently, the Congressional Budget Office – the green eyeshade folks who keep track of the cost of everything the government does – concluded that making prescription drugs in Medicare more affordable does, in fact, save some money later on by reducing things like hospital admissions. As a result, filling in the doughnut hole is going to cost about 40 percent less than was previously forecast. At a time of tight budgets, that’s great news for all of us.

Of course, there are things you can do to help keep your own prescription drug costs down. You should make sure you’re getting the most from your prescription drug coverage. Many plans have preferred pharmacies and mail order services that can get you better prices. Ask your doctor and pharmacist about whether generics are available for any of your name-brand medications, and take the generics whenever possible. And if you have limited income and financial resources, you might qualify for the Extra Help program that’s run through Social Security. You can find out more at the Social Security website, http://www.socialsecurity.gov/prescriptionhelp, or by calling 1.800.MEDICARE. Some states also have their own programs to help people with high drug costs.

As 2013 starts, between the fiscal mess in Washington and everything going on in our own lives, we’ve all got a list of things to be concerned about. But it’s good to know that the Part D prescription drug doughnut hole is soon going to fall off that list of concerns.

Families USA is the national organization for health care consumers.They have advocated for universal, affordable, quality health care since 1982. Ron Pollack is the Executive Director of Families USA.

in News
Related Posts

Riviera Mansion on Market for $25 Million

May 4, 2021

May 4, 2021

 6 bedroom, 10 bathroom Riviera mansion hits market  By Chad Winthrop A nearly century-old Riviera mansion complete with a speakeasy...

Venice’s Fox Theater Revamp

May 4, 2021

May 4, 2021

A developer wants to revamp the historic Fox Theater building in Venice. Learn more in this video made possible by...

Edify TV: Site Work Begins on Nearly Billion Dollar LAX Station

May 4, 2021

May 4, 2021

Site work has begun for a nearly billion dollar light rail transit station coming to LAX. Learn more in this...

Nearly 50-Unit Affordable Housing Complex Breaks Ground in Santa Monica

May 4, 2021

May 4, 2021

Development combines retail and residential units  By Toi Creel A 50-unit affordable housing complex recently broke ground in Santa Monica’s...

Edify TV: Concert Capacity Rules Issue for Small Venues

May 4, 2021

May 4, 2021

Live music is back in LA County but the owner of a Westside jazz club says reopening will have to...

Santa Monica City Council Gives Green Light to Pursue Main Street Closures

May 3, 2021

May 3, 2021

Lawmakers instruct staff to develop proposal that would close Main Street to vehicles on weekends By Sam Catanzaro Santa Monica’s...

Rents on The Rise In Santa Monica: Santa Monica Beat – May, 3, 2021

May 3, 2021

May 3, 2021

Local news and culture in under 5 minutes. * Rents on The Rise In Santa Monica * Natural Gas Leak...

Woman Killed by Vehicle on 10 Freeway in Santa Monica

May 3, 2021

May 3, 2021

Victim struck at Cloverfield Boulevard on-ramp Sunday night By Sam Catanzaro A woman was struck and killed by a vehicle...

Santa Monica Police Use Naloxone to Save Overdose Victim in Park

April 29, 2021

April 29, 2021

SMPD save woman who has overdosed on Oxocodone By Sam Catanzaro Santa Monica police used Naloxone to save a woman...

Edify TV: Could Penmar Golf Course Become Affordable Housing?

April 29, 2021

April 29, 2021

Under a state bill facilities like Penmar golf course could be converted into space for affordable housing. Learn more in...

Hard Kombucha Tasting Room Opens on Main Street

April 29, 2021

April 29, 2021

JuneShine opens on Main Street in Santa Monica Toi Creel A hard kombucha tasting room has opened on Main Street...

Italian-Style Raw Seafood Bar Comes to Santa Monica

April 29, 2021

April 29, 2021

Crudo e Nudo, a new Italian-style raw seafood bar on the Westside offers sustainably sourced fresh fish, shellfish and crustaceans....

Film Review: The Serpent

April 28, 2021

April 28, 2021

8 One-Hour Episodes Miniseries Released April 2nd on Netflix The Serpent is an intense miniseries based on the horrific true...

Heal the Bay Aquarium Under Santa Monica Pier Reopens

April 27, 2021

April 27, 2021

Aquarium opens with patio exhibits for weekends By Sam Catanzaro The Heal the Bay Aquarium under the Santa Monica Pier...

Santa Monica College Student Film to be Screened at Cannes

April 27, 2021

April 27, 2021

SMC student film “Broken Layers” accepted into The American Pavilion at Cannes By Sam Catanzaro Santa Monica College (SMC) student...