August 6, 2006 /

ACTION ALERT: Time For A Doughnut Hole

No I am not talking about a sweet treat of a doughnut hole. This doughnut hole is part of the Medicare changes and is actually one that is really hitting seniors hard. It is a loophole in the new Medicare coverage that many seniors were not aware of, but are quickly finding out about. Here […]

No I am not talking about a sweet treat of a doughnut hole. This doughnut hole is part of the Medicare changes and is actually one that is really hitting seniors hard. It is a loophole in the new Medicare coverage that many seniors were not aware of, but are quickly finding out about. Here is how it works.

  • Medicare part D will pay 75% of your prescription costs for the first $2,250 worth of medicines for the year.
  • Once you reach that limit, the coverage drops to 0%, leaving seniors paying the entire prices
  • Once you prescription costs hit $5,100 for the year then Medicare kicks back in and covers 95% of the costs.

Now these amounts might seem like a lot, but consider the number of drugs a lot of seniors are on. You get a person suffering from emphysema and congestive heart failure, then that person taking 15-20 different prescriptions a month is not out of the question. It is not uncommon for one person to have a monthly medicine bill exceeding $1,000 and in some cases $2,000 or $3,000.

So these people only got to pay $3,000 a year for their medicines. This isn’t bad that bad, is it?

We over 33 million seniors in this country depend upon social security as their only source of income. The average monthly social security income for these people is only $1,000. If these seniors live in public/HUD housing, 1/3 of their income goes to rent. Now add into that the soaring energy prices, increasing prices at the grocery store and ever rising cost of living. These citizens of the United States are now struggling to scrape together every needed penny just to live and that is without their medicines. If a senior has to pay even $100 a month for their medicines (a very low amount), they are not looking at struggling even harder.

Since the new Medicare program went into effect first of the year, it has been coined a giveaway to not only the insurance companies, but also the drug companies. This could not be more true. I can sit here and tell you horror stories I hear every day of a citizen of this country, who spent their entire life working and being a good citizen, now being screwed over by the government in their golden years. While these people get the shaft from their country, the drug and insurance companies are seeing soaring profits.

Of course the Republicans are out singing their praises for this new program, as I pointed out here, while the Democrats are out talking about the actual problems. These problems are very real and ignored by the Republicans and the Republican controlled government. The Democrats are also working to right the wrongs of these programs:

Horror stories about people falling into the donut hole are beginning to roll in. Senator Frank Lautenberg (D – N.J.) has introduced a bill that will eliminate the coverage gap in Medicare Part D known as the “Donut Hole.” This legislation would require Part D providers to offer uninterrupted drug coverage.

According to Senator Lautenberg, “Prescription drug plans that suddenly stop in the middle of the year are a cruel joke.” In 2005 he offered an amendment to the Prescription Drug Plan that would have required Medicare beneficiaries to sign a disclaimer that they understood, in plain English, the coverage gap in their plan before they could enroll in a Part D plan. The amendment was defeated 43-56 with every Republican in opposition.

“The current coverage gap is fundamentally unfair and should never have been allowed in the first place,” said Lautenberg.

A bill in the House of Representatives hopes to reduce the cost of prescription drugs by requiring Medicare to negotiate lower prices with the drug companies. Recent studies have found that drug prices charged by Medicare Part D drug plans are 46% higher than those paid by the Veterans’ Administration that does negotiate with the pharmaceutical companies.

This information is supplied by NeedyMeds, a non-profit organization, who is out there to help people get their needed medications.

Now remember how I said the new Medicare program was a hand out to the drug companies? NeedyMeds even points out just how much of a handout this really is:

Drug costs paid by Medicaid had been controlled by a law passed in 1990 which ensured that Medicaid would pay no more that the best price paid by a commercial purchaser and would also pay no drug price increases that exceeded the rate of general inflation. Medicaid recipients were automatically rolled into Medicare Part D. Brand name drugs rose by 3.9 % in the first three months of 2006. This was four times the rate of general inflation. These drug prices where passed along to Part D enrollees.

This is corporate welfare sponsored by the government and given at the cost of healthy living for the seniors of this country. Now consider the Pandora’s box of medicine. You have drug company representatives, who are very much like the lobbyists in Washington. These representatives’ job is to go out to doctors offices and sell that doctor with their product. They do so with gifts, luncheons, you name it. Many doctors fall into this and start prescribing that companies drugs (don’t believe me? Look around the doctors office next time your in at all those posters hanging on the wall and whose name is on them). That company now gets richer and they do so by the very limited wallets of our seniors.

Now onto the insurance companies. These are the biggest vultures. They are sending agents out to seniors homes pushing their coverage onto them. Just this week, I learned of one such case where a senior did not want to leave his old insurance and the agent from another company talked him into getting their coverage and said both plans would help him out. This was a flat out lie and actually ended up costing this senior, who has a monthly income of $700, a whopping $500 a month. This is because his Medicare now stopped picking up the extra because of the double coverage.

Insurance companies are out in full force trying to increase their profits and screw over our seniors. The government has acted as the enablers for this corruption that is costing our “greatest generation” dearly. The Democrats bill addresses this problem also:

The House bill also allows seniors to choose a plan administered directly by Medicare eliminating the outsourcing of drug coverage to private plans that has resulted in an expensive and complex program.

This legislation also extends the enrollment deadline to December 31 to eliminate the lifetime penalty now in effect. This bill also seeks to stop drug plans from increasing co-payments and creating administrative hurdles for changing plans mid-year.

What is needed of you out there is to help get this bill passed. We need to contact our representatives and senators and encourage them to pass this much needed legislation. With the way pensions are screwed with and insurances taken away from American workers today, every single one of us face the threat of being screwed over by Medicare in the future. We must put a stop to this now and tell the government we want the program fixed and the corporate welfare to stop.

Click here to contact your Representative

Click here to contact your Senator.

Please take a moment to help get this legislation through. Our seniors deserve it and the American people deserve it. We are all getting older and approaching the age of retirement and will soon need the same help ourselves.

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