Reed Seeks to Prevent RI Seniors from Falling Into Medicare Prescription Drug Donut Hole
JOHNSTON, RI In an effort to help thousands of Rhode Island seniors avoid medical and financial hardship, U.S. Senator Jack Reed (D-RI), a member of the Health, Education, Labor, and Pensions (HELP) Committee, today warned Medicare Plan D participants about the major gap in Medicare drug coverage, also known as the donut hole. The donut hole is a $2,850 coverage gap in the new Medicare drug plan that will force thousands of Rhode Island seniors on Medicare Plan D to pay out of pocket for prescription drugs. At the Johnston Senior Center, Senator Reed stated: Many Rhode Island seniors are unaware that this coverage gap exists and only learn about the lapse after theyve fallen into the donut hole. To add insult to injury, these beneficiaries are expected to keep paying monthly premiums for their drug plans even though they receive absolutely no coverage in return. We need to urgently fix this problem or it will continue to happen year after year, and the donut hole will only get bigger and bigger.Under the standard Medicare Part D drug benefit, drug coverage ends after a Medicare beneficiary spends $2,250 on prescription drugs and does not resume until the beneficiary reaches $5,100 in total drug expenditures. This leaves a coverage gap of $2,850 during which beneficiaries must pay the full cost of their prescriptions. Even though beneficiaries receive no help with their drug expenses during this gap, they still must pay their monthly premium.This is outrageous. Many of the people who fall into the donut hole suffer from chronic conditions that require them to take several medications each day. They cant afford the cost of these drugs without Medicare and their health will suffer if they are forced to stop taking needed prescriptions, said Reed. According to the Kaiser Family Foundation, nearly seven million seniors are expected to fall into the donut hole in 2006. Today there are over 130,000 Rhode Islanders on Medicare with drug coverage. Roughly a third of them, or as many as 43,000 seniors, are expected to fall into the donut hole. And this percentage is only expected to grow in the coming years as drug prices continue to escalate.In an effort to save taxpayers money and pass these savings on to Medicare beneficiaries, Senator Reed voted to give the federal government the authority to negotiate the best deal for Medicare prescription drugs similar to the power the Department of Veterans Affairs (VA) has successfully used to negotiate lower drug prices for veterans as well as an alternative prescription drug plan which had no donut hole.Today, Senator Reed announced his support for two additional proposals to help fill in the Medicare donut hole gap: The Prescription for Fairness Act and The Helping Fill the Rx Gap Act. The Prescription for Fairness Act is simple: Beneficiaries should not have to pay monthly premiums when they have no drug coverage. This bill waives the Medicare Part D premium for any month that a senior falls into the donut hole. During this time, the Secretary of Health and Human Services would be responsible for the monthly premium costs, said Reed. Another aspect of the donut hole Reed is working to address is the fact that expenditures by other drug subsidy programs do not count towards beneficiarys true out-of-pocket costs (or TrOOP) during this lapse in Part D coverage. Medicare beneficiaries on fixed incomes should not be penalized for seeking assistance from other programs that provide prescription drugs or drug assistance. So I am also cosponsoring The Helping Fill the Rx Gap Act to allow costs incurred by federally qualified health centers and pharmaceutical manufacturer-sponsored Patient Assistance Programs to count toward a beneficiary's annual out-of-pocket threshold, concluded Reed.Reed said he hopes these initiatives will continue to garner more support from his colleagues in Washington as more seniors around the country run into the donut hole problem and demand that lawmakers take action.