Thursday, August 5, 2010

Medicare Doughnut Hole

Variable "out-of-pocket" Costs of
Prescription Medications in the Medicare Program
(Excerpt) "... about eight million participants in Medicare Part D, the prescription drug program, fall into [the 'Medicare Doughnut Hole'] each year. Currently, the gap opens when a Medicare recipient and his plan have spent $2,830 on prescriptions; at that point, he must pay for medications himself until he’s paid $4,500 out of pocket. Then Medicare coverage resumes ...
Starting next year, 50 percent discounts on name-brand medications, plus smaller discounts on generic drugs (because they’re already discounted for Medicare participants), will help reduce that burden. The proportion that seniors will have to pay will fall steadily until, by 2020, the doughnut hole is scheduled to disappear ...
Medicare participants who land in the doughnut hole this year will get checks for $250; the first were mailed out [June 2010]. About four million people will qualify for these refunds (the other four million have incomes low enough to benefit from a program called Medicare Extra Help ...
One caution: Medicare will automatically generate the refund — which is tax-free — about six weeks after a senior hits the $2,830 threshold. “Automatically” means that Medicare Part D participants don’t have to fill out any paperwork or answer any questions in order to receive their checks ... “What we’ve been seeing, sadly, is people calling Medicare beneficiaries at home and saying, ‘We can help you get your check,’ and asking for information,” [said] Marilyn Tavenner, acting administrator of the federal Centers for Medicare and Medicaid Services ... Such overtures are not only unnecessary — they’re probably a scam ...
[Pre-Seniors & Senior Citizens] shouldn’t disclose their Medicare numbers to anyone except a physician or pharmacist, a trusted family member, or Medicare itself.
Source: The New Old Age
$250 "Medicare Doughnut Hole" Rebate Check
Hear Medicare's official message about the $250 Part D rebate check
on this audio clip (00:30).

Note: There might be health insurance plans or programs not mentioned here that may or may not be involved with the 'Medicare Doughnut Hole' and related prescription medication costs.

Some Pre-Seniors & Senior Citizens Are
Drinking Dangerous Amounts of Alcohol
(Excerpt) "... study included 3308 current drinkers age 60 and older ...

Older adults ... [are] at risk if they ... consume one to two drinks on most days and take select medications ...".

Source: UCLA finding
A Question for Blog Readers
After one's out-of-pocket costs for prescription medications totaled $2830 - $4500 annually, the government issued a one-time $250 rebate check. Did this refund significantly help that individual manage the reduced but also reoccurring out-of-pocket costs remaining in the 'Medicare Doughnut Hole' until 2020? Could this problem be better solved?
See also: Blog Comments Add Value to the Topic

LIFT (Link I Found Today)
The following is simply the last segment to read at the end of this post and may or may not be in any way appropriate or relevant to anything ...
LIFT: California Mid-State Fair - Julianne Hough and
audio clip (0:30). Sorry, the links here do not include audio of her singing.
You and your wife -- and your best cowboy hats -- had to be there in the setting sun light ...

Photo Credit: QwkDrw, July 2010

Next post scheduled 8.19.10, "Suburbs Diversify and Transform"