Help For Medicines is Available For Your Patients
For a lot of seniors who live on a fixed income, Medicare Part D has been an answer to their prayer. The Medicare Part D donut hole for those seniors who have a chronic condition, can be a real shock. At this time of year there is much talk regarding the coverage gap or donut hole. How does it work, what is it, and why is it there? How does it provide prescription drug help?
Medicare’s Part D cost was reduced by creating the coverage gap. The yearly limit for Part D is set each year. $2400 was the 2007 yearly limit. $2510 is what the annaul limit was increased to in 2008. The limit is $2700 in 2009. The amount is calculated on the total costs of the prescription medicine that you receive. This includes what the insurance company pays and your co-pays. If the insurance company pays $500 and the recipient pays $50 for a drug, the dollar amount that is applied toward the annual amount is the entire amount of $550.
During the time your are in the coverage gap, you must pay for all of your prescription drugs out-of-pocket. There is coverage for your generics when you are in the donut hole or coverage gap. The cost of most generic drugs is so small that the benefit of having them covered by a Part D plan is not that much of a benefit. For some people it could be worth it to have prescription coverage for generic drugs, everyone’s situation is different.
For Part D patients with chronic health conditions which often require high priced medication for treatment, the donut hole can be reached in a matter of weeks. Reaching the coverage gap as early as February is not uncommon. Steering people to buy less costly medications when possible is the reason for the coverage gap. This punishes those people who must use high priced prescription drugs because nothing else works.
Patients with rheumatoid arthritis can fall into the coverage gap within 2 or 3 months due to the high cost of Enbrel. The option at this point is to pay for the prescription medication at full cost for several months until the catastrophic coverage portion kicks in or suffer the potentially disabling consequences of stopping their prescription drug. The cost of Enbrel is approximately $50 per day. There are a lot of seniors who are unable to afford for that.
Patient assistance programs will help those people who qualify.
Going directly to the pharmaceutical company can be most helpful in getting low or no cost prescriptions. Call the company and ask about their Prescription Assistance Program. Most all drug manufacturers offer such programs, which enable consumers to receive prescriptions they need at a price they can afford. A lengthy application co-signed by your healthcare provider is typically necessary for entry into the program. Patient Assistance Programs run by drug companies have been in existence for over 15 years. These programs are designed to assist eligible people who can’t afford their prescription drugs due to limited income or other financial problems. Drug companies did not want their low income customers to be forced to make a choice between paying for life saving prescription medicine or for paying for rent or groceries. As a result, patient assistance programs came into being as part of the company’s philanthropic efforts. Until relatively recently, few patients knew about the existence of these programs or could follow the complicated application process that was required for participation. In many cases several applications had to be filed. Please do your research and get the help with prescriptions that you need.
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