"Every time somebody in Washington says what a wonderful benefit this is, I think they have to look a little closer."
That's what a consumer says in a Washington Post story about the millions of older Americans who are now hitting the "doughnut hole" in Medicare drug coverage. That means they've spent through the first wave of coverage are now in a hole wherein they must pay the full cost of prescription drugs - or stop taking them.
The Post reports: "Some seniors knew nothing of the coverage gap until they were hit with a bigger drug bill, advocates say.
"Virtually everyone who calls to say they've been denied coverage, they're shocked," said Robert M. Hayes, president of the Medicare Rights Center, a nonprofit that helps seniors navigate Medicare. "Trying to explain that this is the way the program was created by Congress angers folks who think it makes no sense. Many people feel blindsided."
The coverage gap was one of the most contentious elements of the 2003 legislation that created the new benefit. It ends federal payments for a person's drug purchases once an annual spending limit is reached, resuming them only after the beneficiary has spent thousands of dollars out of pocket.
Proponents saw the unusual setup as a way to provide some help to all beneficiaries, and substantial help to those with catastrophic drug costs, and yet not break the bank in a federal program that is expected to cost hundreds of billions of dollars over the next decade.
Nine months into the program, as more and more seniors reach the threshold that puts them in the gap, many see it as a headache -- or worse."
Did it take a genius to figure this out? Was it really necessary to perform a study to find this out?!! Ask a nurse, or a nursing manager....they'll all tell
Posted by: eHealth at September 27, 2006 12:18 AM