“Now, at least we know we’re covered,” said Sandy Gibson, 66. “We order our medication over the phone, our insurance plan has a pharmacy in Ohio and if we see our doctor in Florida, we can buy medicine down here.”
“This is a new program and people are trying to learn about it, and concerns about travel are questions people need to ask,” said Scott Parkin of the National Centers on Aging. “It could be a problem, but we probably won’t see this until more people start heading north.”

Read more on this topic.

“Back in September, when we did presentations, people were saying, ‘What is this?’ Now it’s a whole different ball game,” she said. “People are asking which company has credible plan. I’m finding people are much more knowledgable about it now.”
“We still expect that there are the procrastinators,” Tredennick said, “and we expect the next two weeks to get quite a few phone calls.”
“So it’s not a huge penalty, but it adds up, and it compounds,” she said. “It’s a way to push them into the insurance pool.”
“Right now the waits are less than a minute,” she said. “But if people wait until May 13 to call, we don’t know that they’re going to be able to get through.”

Read more on this topic.

In announcing the hearing, Subcommittee on Health Chairman Nancy Johnson stated, “Today more seniors than ever before have access to affordable prescription drug coverage through the Medicare drug plan, and more seniors are signing up every day. The Medicare drug benefit is the biggest expansion of the program since it was created 40 years ago. Today more than 27 million Medicare beneficiaries have drug coverage; including 8 million who have signed up for stand-alone drug plans. During this hearing, we will examine how this significant new program is being implemented and discuss with Medicare beneficiaries, federal officials and health care providers how we can improve the drug benefit going forward.”

Read more on this topic.

Dr. Mark McClellan, administrator of the Centers for Medicare and medicaid services, summarized the policy this way: “In general, a plan cannot change your coverage for the drugs you are using during the year. The stability of drug formularies is extremely important for many of our beneficiaries.”
Karen Ignagni, president of America’s health insurance plans, an industry trade group, said her organization supported the new federal requirement. She said the federal policy “will have a financial impact,” increasing costs for insurers under Medicare. But, she said, “you need to balance that with the goal of providing continuity of drug coverage and peace of mind to beneficiaries.”.

Read more on this topic.

“The people who need this the most can fight the least,” says Victoria D’Angelo of Denver, a former legal secretary now living on Social Security disability payments while battling bipolar disorder, asthma, high blood pressure and other ailments. “We don’t have the strength. We don’t have the mental ability.”
Before Medicare, 6.4 million of them had drug coverage through medicaid. Others had state help or free drugs from drug companies. “They had good coverage before this program began,” says Ron Pollack of Families USA, a liberal health care advocacy group. Now, “there’s a sizeable group that is actually worse off.”
Medicare Administrator Mark McClellan has urged others to join them, “so beneficiaries can have the Medicare program and the assistance programs.”
In Lafayette, La., Dorothy Broussard, 58, went a week in February without her arthritis and multiple sclerosis drugs because she was in the “doughnut hole.” Her prescriptions came to about $1,400 per month. “I almost passed out in the pharmacy.”

Read more on this topic.

Medicare’s new prescription-drug program has increased out-of-pocket costs for about one in five participants, causing some to risk their health by reducing or eliminating medications.
ADVERTISEMENT

Though most of the more than 30 million beneficiaries enrolled in the program are saving money, two recent surveys suggest a substantial minority of seniors and people with disabilities are not:

• A Kaiser Family Foundation poll taken April 6-11 found 55% of 154 seniors who had enrolled said the plan would save them money, 19% said it would cost more, and another 19% said they would break even.

• A KRC Research poll taken March 15-20 for the Medicare Rx Education Network, a consortium of groups working to implement the law, found 59% of 201 enrolled seniors saved money, but 23% did not.

Read more on this topic.

In January, Banko got interested in Medicare’s new drug benefit, which had debuted that month. But the details seemed “totally confusing.”
“We still have some hiccups,” said Lisa Federico, a GeorgiaCares coordinator. “But we’re not getting nearly the number of problem calls we once did.”
Some with high drug costs have already fallen into the doughnut hole, said Robert Hayes, president of the Medicare Rights Center. Consumers who reach this gap, he said, “will be surprised and pretty unhappy.”
Now his total payment is $15 because Bradley qualified for a low-income subsidy, which means he pays no premium and has low co-pays. “It’s great,” he said. “And now I’m getting the drug I couldn’t afford.”.

Read more on this topic.

“By standardizing the information that a health care provider or supplier must use in order to bill Medicare, we will be better able to protect the Medicare program and assure providers and suppliers that they will be paid promptly,” said, Timothy B. Hill, Chief Financial Officer and Director, Office of Financial Management at CMS. “The new rule will also help bring us even closer to the development of an electronic medical record.”

Read more on this topic.