Health & Medical Readers Comments

Medicare’s 2007 Part D

“WHAT TO LOOK FOR IN MEDICARE’S 2007 PART D”

We are starting into another year of an incredibly complex and inadequate “Part D” plan to assist medicare recipients (anyone over 65) with the purchase of the drugs necessary to maintain life, health, and comfort.

After having done many hours of research last year before enrolling, it will be a quicker process this year. If you have significant medications to purchase on an ongoing basis such as a diabetic or other chronically impaired individual, this is actually going to be simple. At least in Idaho, there is only one company offering a policy providing drug assistance without incurring the second $3,026.25 deductible. So much for private competition!

Last year there was only one company willing to provide this coverage and 2007 presents the same coverage only with a different company. While we will change from Humana to SierraRx for 2007 at a substantially increased cost of $73.50, up from the $53.00 of last year, it leaves me wondering what we will do in 2008 if Congress continues to spend their time protecting the drug companies profits instead of the citizens they were elected to protect, and another company decides to bail on a meaningful program.

While there are others claiming to provide “doughnut hole” coverage, in reality, all the others, including Humana, will only cover generics during the doughnut hole! If I could get by on generics there would be no need for part D! Just try to find a “generic” insulin for instance!

It has to be a tremendous shock for many seniors after paying out (for 2007) an initial deductible of $265 followed by 25% copays until purchases total $2400 altogether, and to now be confronted with the news that there is another $3,026.25 “deductible” to meet before they can have any more drug assistance! How many persons would even subscribe to an “insurance” program for drugs wherein they had to meet a $3,291.25 deductible?

My advice to seniors is the same as last year. That is if your prescription costs are quite high and many of the drugs are brand name, even preferred brand, take the SierraRx in 2007 as the $882 annual cost will be money well spent. If your drug needs are more modest such as a projected total of $3,000 or so, take the cheapest plan available (in Idaho that is Humana for $13.30 per mo.) and be prepared to purchase any overage above the $2,400 out of Canada. If your costs equal $2,400 you’ll get $1,482 assistance from the program after deducting the premium and deductible. However, at $2,400 your coverage is over for lower usage patients and all that’s left are premiums to pay!

Finally, if you have the capability, computer, etc. to make sense out of this and understand and explain, please be willing to assist other seniors or others on Medicare or Medicaid because community outreach programs, doctors and pharmacists are never going to prevent many from falling through the cracks and depriving them of the medications they need.

Jim Collins

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