For the Most Needy, A Tough Switch
Unbelievably, the new Medicare Part D plan will nicely screw those who most need their medications.
What I’m having a hard time understanding is why more people aren’t up in arms about these changes. “It doesn’t affect me.” Fine, it’s going to affect your parents or grandparents though, and it’s definitely going to affect you eventually.
If this is “progress,” it feels like the “two steps back” kind.
To those administering Medicare’s new Part D drug benefit, Keys is known as a “dual eligible.” Her mental health condition is a substantial enough disability to make her eligible for Medicare. And because her income is too low to support herself and her teenage son, she qualifies for Medicaid, the program for the poor that now covers almost all of her drug expenses.
The nation’s 6.4 million dual eligibles — more than 200,000 of them live in the District, Maryland and Virginia — present a big test for Part D, which goes live on Jan. 1. They are among Medicare’s most vulnerable beneficiaries, and when the clock strikes midnight on New Year’s Eve, the dependable and robust drug coverage they receive through Medicaid will disappear, replaced by more restrictive and complicated plans.
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One Comment to
“The End of an Era, The Beginning of Confusion”
While I agree that the transition has been confusing, it’s not as bad as it could be. I work with the mentally ill population in rural Pennsylvania who are being affected by this change, and those who are dual were automatically enrolled in the extra help program through Social Security that pays for their premiums and keeps their copays low (the average has been $1-5). For most of those in my county, nothing has changed except the card they show at their pharmacy. This program has also been very beneficial for some who qualify for Medicare but who have incomes slighty too high for Medicaid–these people had no prescription coverage at all prior to this change, and now some of their out-of-pocket costs will be deferred. I’m not familiar with how other states are being affected by these changes, nor do I know if it is different for those areas with managed care. I do know that those with whom I work are either not affected or benefited by the change–so it’s confusing but not so bad for some.
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Last reviewed: By John M. Grohol, Psy.D. on 23 Dec 2005
