Facts About Medicare Part D

Developed by Civic Action's Senior Ministries Network

In 2003, the Medicare Modernization Act was enacted to provide prescription drug coverage to Medicare beneficiaries. Instead of maximizing prescription drug benefits to promote the health of vulnerable citizens, it uses our tax dollars to confer big profits to pharmaceutical companies and managed care organizations. It is confusing and costly and over 6.4 million low-income seniors are financially and medically afflicted by its implementation.

THE COVERAGE GAP (DONUT HOLE)
Nearly one-half of Medicare beneficiaries will fall into the coverage gap or "donut hole." While continuing to pay premiums, beneficiaries will have no drug costs coverage between $2,250 and $5,100 in personal expenditures for drugs.

UNAFFORDABILITY
By 2013, the eighth year of the program, the deductible and
coverage gap are projected to grow by 78 percent; seniors will pay a $445 deductible and those with the largest drug bills will be entirely responsible for drug cost over $5,000.

BENEFITS TO BIG BUSINESS
Pharmaceutical companies will reap additional profits estimated at $139 billion over 10 years due to this legislation. In contrast, the typical Medicare beneficiary will receive approximately $800 in drug benefits each year.

NO PRICE CONTROL
The legislation explicitly prohibits the federal government from using its purchasing power on behalf of 40 million beneficiaries to bargain with drug companies for lower prices.

PREMIUM PENALITIES
The Act imposes an unfair penalty on beneficiaries who do not sign up for the drug benefit by increasing the premium amount one percent per month for each month an individual without coverage delays enrollment.

THEY CAN CHANGE DRUGS, BUT YOU CAN’T CHANGE PLANS
Insurance companies can take drugs off of their approved coverage list, which beneficiaries use to determine plans that will work for them, but patients are locked into their plans until the next year.

PRESCRIPTION DRUG COVERAGE SHOULD BE:

Universal—Income and assets do not determine cost of benefits.

Voluntary—People are not forced to take an unpredictable drug plan from private insurance companies.

Affordable—Control the increase in premiums and deductibles to ensure long-term affordability

Comprehensive—Eliminate the gap in coverage

Consistent—Prohibit insurance companies from taking drugs off of the approved drug list until open enrollment period.

Regulated—federal government should negotiate lower drug prices from drug companies on behalf of Medicare beneficiaries

These facts were taken from: http://www.retiredamericans.org and http://www.usaction.org. Visit these links for more information.

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