New Medicare Drug Program

Discussion in 'Fibromyalgia Main Forum' started by Mikie, Sep 25, 2005.

  1. Mikie

    Mikie Moderator

    This new program, which is going to be very pricey, is a big relief for pharmaceuticals. For years, most drug companies have had programs for the medically indigent whereby they could receive drugs at no cost or $5 for the S&H. With the new program, the medically indigent will continue to get their drugs but now, the burden shifts to the American taxpayers instead of the profit bloated pharmaceutical companies.

    With so many on Medicare who require expensive medication, the govt. missed a big opportunity to negotiate reduced costs to patients on Medicare. American Senior Citizens on fixed incomes should at least be able to buy their drugs at Canadian prices. By reducing costs to everyone and keeping the pharmaceutical indigent patient programs for free medications, it would have been a win, win situation for everyone except Big Pharma. With this new program, Big Pharma is getting even richer off taxpayer money. Such a deal!

    Love, Mikie
  2. Bailey-smom

    Bailey-smom New Member

    While driving yesterday I heard 2 drug companies advertising their programs to give meds to people who can't afford them. I think more people should fill out that paperwork. I know that my hubby & I don't qualify financially but I am going to see if the company that I get mine from has a program because my scripts are over $500/month and I know @ times they will still consider a person if they don't fit the financial guideline.

    I know that the new drug program will be great for some. . .not so good for others.

    have a good day!
    Kelly
  3. Leenerbups

    Leenerbups New Member

    And I don't understand what is going on. I applied for a drug discount card they offered about 2 years ago.

    But I don't know what this new change is or what I have to do.
  4. Mikie

    Mikie Moderator

    It's been so complex that a lot of people have not signed up for the cards. Beginning next year, indigent people can obtain drugs, depending on income and financial assets. This will be funded through Medicare.

    I do not know whether the pharmaceutical companies will continue to offer free meds through their programs or not because Medicare will be picking up the cost of prescriptions for many who previously got their drugs through the pharmaceutical companies' plans.

    There will definitely be some who will benefit through Medicare's program. I believe medically indigent people should get their drugs. Some will have just enough assets that, even though they cannot afford their meds, they will be expected to pick up a fairly large chunck of the cost. I don't know what they will do. There is a large part of the population who fall through the cracks of these programs.

    My complaint is that this program is unnecessarily complicated, especially for those who are elderly or disabled and may not function cognitively at a high level. Another complaint is that the pharmaceuticals will continue to gouge Americans while selling the same drugs much cheaper in other countries. Seems to me that this program could have been much better thought out and more simple.

    Love, Mikie
  5. rileyearl

    rileyearl New Member

    Amen, Mikie!

    Maybe there will be some logic and reason applied to this mess if all the reps up for re-election lose or come close to losing their seat in the House.

    Thanks for posting!

    Francie
  6. Bailey-smom

    Bailey-smom New Member

    I agree with you. They could have made it much less complicated than they did. It will be very confusing for many people to understand.

    The good thing is you don't have to qualify financially.

    The bad thing is there is not a discount on drugs - only a deductible and then a co-pay type amount that you would have to pay. This does not include the $30 (+) in premium for the prescription policy!

    It will probably need to be looked @ again because I do not know how smooth it will be started.

    Kelly
  7. Mikie

    Mikie Moderator

    You do have to qualify financially if you want the extra benefits available to the people lowest on the financial totempole.

    For the rest, it really is a complicated mess.

    Love, Mikie
  8. Bailey-smom

    Bailey-smom New Member

    If you are qualifying for additional benefits now it will not change. If you give me an example I can take a look. For some reason the Medicare site is easy for me - I am always looking for my clients!

    Kelly
  9. puppyfreak

    puppyfreak New Member

    I just got approved for SSDI in July and since it was retroactive almost 4 years, I was immediately enrolled in Medicare, parts A and B. I called to get info on what it covers and have yet to get anything.
    But the site is fairly user-friendly. I compared my drug costs for the different programs in my area as well as what Costco accepts and I'll probably go with AARP or none. Since I'm being weaned off the most expensive medication my costs are kind of in between so it may not save me any money after the monthly payment and deductable.
    I was on Medicaid for a year and got spoiled getting all my meds and medical care for free. But I was living in a tiny room [which that was all I could afford to rent] so I guess I won't complain about medication costs since I'm now in my own apartment.
    However, I'll probably always complain about how our government creates programs for it's own gratification and monetary gain and tries to pass these off as good for the American people!

    Char
  10. dojomo

    dojomo New Member

    It is just another way of laundering money to the drug companies under the guise of helping the elderly.I just read that medicare premiums will increase 13% next year to help cover the costs. That's $88.50/ month now. Of course our cost of living increase, if we get one, will probably not cover it or we will break even.

    Other things they don't mention is if you have a life insurance policy, retirement account or savings over $13,000 for a single person, you don't qualify. In fact very few will benefit for the covered premiums and low costs. It will help the extremely impoverished, but they are covered anyway under medicaid. I think this is a way to dismantle medicaid, because those the qualify for medicare plan will NOT qualify for medicaid and actually lose benefits, like dental and eyewear, (which medicare never covered). Dual eligible People will be atomatically swiched
    to medicare.

    I also heard they were tossing around the possibly postponing the drug plan to help cover the costs of the hurricanes. You know.......steal from the "almost poor" and give to the poor. I mean really? Haven't the rich suffered enough in this country? Why should they have to chip in and help a counrty that made them wealthy? The greed is nauseating! God forbid we raise taxes.

    I think if God had any intensions with these hurricanes, is to shove in our faces, the actual magnitude of the poverty crisis in this contry, the average income in "lesser" New Orleans was $7000/ year. You could plainly see most of those people were sick or children.

    They also blackmail you into signing up for a plan now, even if it doesn't benefit you, by telling you every year you wait, the premiums will go up. If you don't need it now, eventually you will, because you will have to exhaust all you savings on drugs. The health care corporations will not be satisfied until we all die penniless and they have the pot. example: I pay $15 a month for my thyroid, I should pay another $25 for a drug card? With a $250 dedectible? And if I don't, when I need a more expensive drug, my premium will skyrocket?

    Another lesser known thing is........not all policies cover all drugs, and they can switch the lists of drugs they cover any time they want. AND drug companies can raise the prices anytime they want.

    This plan will cost tax payers $85 million/year. ($850 bil over 10 years) THERE IS ONLY 50 MILLION ON MEDICARE! If only a handful benefit it is a windfall in the billions to the drug companies. GWB has adamently stated he would VETO any bill that comes across his desk that may change the new drug plan, like capping drug costs

    Now.......imagine if GWB gets his way and privitizes SS. There will be so many more homeless and sick in the streets we will look like a third world country with an elitist regime.

    This country has lost its heart for the sick and poor, not the average American, but the corporate world. I encourage everyone to register and vote in mid term elections in 2006............DJ
  11. Bailey-smom

    Bailey-smom New Member

    I’m sorry - didn’t want to raise anyone’s blood pressure with this:) It is a touchy subject - that I understand, my prescriptions run about $500 (+) every month - talk about taxing on the pocketbook! I just think that people are a bit misinformed on the new program and I thought I could help so at least the correct info is getting out there - I’m not saying the program is the right thing to do by any means but it is a benefit to people who have to pay thousands of $$ out of pocket every year for prescriptions.

    What I do know. . .

    It is not a drug card - you will buy an insurance plan from a private company - not medicare

    The government says which drugs are covered under each plan & you choose the plan you will need

    There are some people whom qualify for prescriptions now that will still qualify because this is a strictly voluntary plan.

    We should talk “nice” about this or else this post will disappear. Like I said before - if you have questions I can look them up - like Char said, the site is pretty user friendly:)

    Have a great day!
    Kelly
  12. dojomo

    dojomo New Member

    If your drugs are now $500.00, there is no ceiling, your drugs could double. And you may pick a plan that is good for you now, but the insurance company can change the drugs they cover. There is no real INSURANCE here.There is also a "doughnut hole" of no coverage. You stand to still spend over $5000/year. This is devastating for those with SS as their only income. With some changes, like limiting drug costs and mandatory coverage of certain drugs, that would be insurance. They are not willing to guarantee these things

    And for the MANY that don't benefit, our medicare costs are rising. I'm happy for those that will benefit,but It should help everyone for what it is costing the taxpayers. There is no reason these adjustments can not be made, but it was made clear that it will stand as is with NO changes...........
    [This Message was Edited on 09/28/2005]

    Drugs definately not covered: ALL BENZODIAZEPINES AND BARBITURATES


    Benzodiazepines, widely used for management of acute anxiety, panic attacks, seizure disorders, and muscle spasms in those with cerebral palsy or other disorders; and barbiturates, of which primary concern is phenobarbital, a drug widely used in the elderly for treatment of seizures

    For Medicare beneficiaries who need a benzodiazepine or barbiturate and who are unable to pay out of pocket, practitioners will be forced to use alternative medications that will be less effective, more costly, or even toxic, according to the study. Additionally, if patients are abruptly taken off benzodiazepines and barbiturates, they could experience severe withdrawal symptoms including seizures and other acute emergencies that would result in increased expenses for Medicare Part A and Part B from hospitalizations. Discontinuation of these medications requires a slow, careful gradual dose reduction over several months. About one in four of the 6.4 million dual eligibles currently take benzodiazepines, known buy such brand names as Valium, Restoril, and Xanax.

    Over-the-counter medications, including agents for pain, constipation, dyspepsia, and other common conditions
    Many over-the-counter medications are needed to work with prescription drugs and are essential for elderly patients.

    Medications used to treat weight loss, such as in those persons who lose weight due to cancer or AIDS
    Approximately 50%–60% of nursing home residents suffer from involuntary weight loss. Unintended weight loss is a life-threatening condition, particularly in the frail elderly (those age 85 and older). Residents experiencing involuntary weight loss may suffer significant decline in health and function, resulting in a higher risk for infection, depression, and death. Therefore, lack of coverage for medications used for weight-related disorders has the potential to adversely impact nursing home residents.

    [This Message was Edited on 09/28/2005]
  13. Mikie

    Mikie Moderator

    There is now a drug plan in effect and one can purchase various cards. Next year, the plan is "enhanced" to include more benefits for people depending on their income/assets and how much they spend out-of-pocket for their meds.

    I believe because there have been two plans, one leading into the other, and this has caused some confusion.

    I beling to a Medicare HMO, so I am not sure how I will be affected by this. I do expect that my benefits will improve.

    Love, Mikie
  14. Leenerbups

    Leenerbups New Member

    I'm on Medicare and I hate to admit it, but I have no idea what this is about. I was never sent anything and I have heard about this from the board.

    How do I choose a plan, etc??
  15. Bailey-smom

    Bailey-smom New Member

    starting on Oct 15th anyone currently on Medicare or elegible for Medicare will receive a ton of info in the mail regarding the new program. You will have until the end of the year to sign up (actually longer) so there will be plenty of time to wade through the info.

    I know that we have a "Shine Volunteer" in our area who has taken many hours of training regarding Medicare Part D. I would think your pharmacy, Medicare or someone could tell you if you have a Shine Volunteer in your area.

    Kelly