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About 21 Million to Get Medicare Drug Coverage

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About 21 Million to Get Medicare Drug Coverage

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By JOHN J. LUMPKIN

Associated Press Writer

WASHINGTON (AP) -- About 10 percent of the seniors and disabled people with little or no prescription drug coverage have signed up for Medicare's prescription drug program, the government reported Thursday.

Medicare opened enrollment for the new benefit on Nov. 15. About 17 million people who already had some form of drug benefit were enrolled automatically by the government, or they will receive newly subsidized benefits through their existing private retiree health care plan.

Other Medicare recipients had to enroll to participate. Of the 10 million to 12 million with little or no coverage, 1 million have signed up. The enrollment period to obtain coverage in 2006 lasts until May 15.

Critics said the small percentage who volunteered for the coverage demonstrates that the Medicare drug benefit program, which relies on scores of private providers that contract with the federal government, is too complicated and unworkable.

"We see it as a searing indictment of this convoluted drug program," said Robert Hayes, president of the Medicare Rights Center, a consumer group. "People are faced with a bewildering array of for-profit insurance plans. These plans are seen as so complex and unreliable that many people in great need of help are staying on the sidelines."

Health and Human Services Secretary Mike Leavitt told reporters that the government expects to sign up between 28 million and 30 million people for the benefit during its first year.

"We're encouraged by the early results," Leavitt said. "You'll find you'll save money and you'll never have to worry about high drug costs in the future."

Medicare provides health care to 42 million older and disabled Americans. Of those, the government estimates between 10 million and 12 million have little or no coverage to help cover the cost of prescription drugs.

The government's figures are as of Dec. 13. An additional 500,000 people are expected to enroll in January, officials said.

The drug programs are managed by private insurance companies that contract with the federal government; the government pays some of the drug costs. In some states, people have dozens of plans to choose from. Additional subsidies are available for low-income people.

Still, one survey suggested a significant number of Medicare recipients think the benefit will help them.

A survey of 401 seniors who will receive the benefit, conducted for an association of U.S. health insurance plans, found that about half the people who signed up for the benefit think it will save them money. The poll by the organization America's Health Insurance Plans also found that more than two-thirds who already spend $100 a month on prescription drugs believe they will save with the Medicare plan.

About 11 million of the 18 million people who were enrolled to receive the benefit already received some prescription drug coverage from the government. An additional 6 million will take advantage of subsidies or programs offered through existing private health plans, such as those provided by companies and unions.

Medicare chief Mark McClellan touted the figures as higher than expected, saying the government projected more companies would drop prescription drug benefits from their retirement plans, forcing seniors to sign up for the government benefit on their own. Instead, companies generally have incorporated the Medicare benefit into their own plans, he said.

Leavitt and McClellan said 21 million people would receive drug benefits through the government; that figure, officials later clarified, includes 3.1 million military and federal government retirees who already receive drug benefits through non-Medicare programs.

In fact, a study by Families USA, an advocacy group that has criticized the Medicare drug benefit as overly complex, found that drug prices negotiated for Medicare prescription plans were higher than those negotiated by the Department of Veterans Affairs.

For example, a year's supply of Lipitor, which lowers cholesterol, costs VA as little as $497.16. In surveys in Washington, D.C., and Cincinnati, the lowest price in a Medicare prescription drug plan the group could find was $717.84 - 1.4 times higher.

The organization said its data shows the savings advertised by proponents of the benefit won't be realized.

The federal government estimates that it will spend about $724 billion over 10 years to provide the Medicare drug benefit. President Bush signed the benefit into law two years ago.

SOURCE:- Associated Press

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The key word in the Medicare Drug coverage is "some". Not all drugs will be covered, especially non-formulary. Generics will be filled rather than brand names.

SW

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Doesnt help me :hearts: .....I pay $400 a month just for myself on healthcare and on top of that it costs me $50 for every doc appointment and $50 for every med....Its just out of control....I dont even take my cholesterol med anymore because of the expense...My government will probably **** me when all is said and done....Sorry...i'm kinda off topic here....

Edited by Petersfine

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I've been on the Medicare Plan D since July of this year. What I have found out is that there is a "hole" in the plan. When you reach a certain dollar amount, the plan will continue to pay for generic drugs but name brands won't be paid for. This means a greater out-of-pocket expense (unless all your drugs are generic). What happens is, you pay for the name brand prescriptions at full price until you reach a certain dollar amount (usually $3600) before the scrip plan kicks back in as a "catastrophic" benefit. Then the plan pays 95% and you pay 5% of the scrips. Not a very advantageous coverage, but it's all the same with all the prescription plans contracted with Medicare. I don't think it's fair, but what else can one do to defray scrip costs.

Medicare has a plan to assist people who cannot afford to pay for their meds when they reach the "hole". However, to qualify for the help, you must be living on less than $1000/month or have no assets greater than $2000 at any time. This is very frustrating for those of us on disability because not all will qualify for assistance and we will have to somehow manage to pay for the scrips when the "hole" is reached.

Sheepwoman :hearts:

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