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Millions on Medicare Fall into Gap
10/24/08 - 01:49 PM
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Millions on Medicare are falling into the gap as they reach the limit on their medical coverage for the year under Medicare Part D.  It’s a 2-year-old Federal program to help cover costs of prescription drugs utilized by about 24 million seniors.  One of those is diabetic Jim Walder.

“I’m in the doughnut hole,” he said, “the dreaded area where Medicare no longer pays for my drugs.”

“A lot of seniors right now are probably looking at this as an issue for them,” said Bay Medical Center Pharmacy Manager Laura Gould, as the end of the year approaches.

“They’re going to have to make a decision either to eat, or take their medicines,” said Walder, “A lot of folks are just not taking their meds.”

Each year, the plan offers $27 hundred worth of coverage.  Then, patients must reach a $43 hundred out-of-pocket before the plan offers more coverage.

“If I couldn’t afford it then I can’t afford it now and I need insulin,” said Walder.

Pharmacists say those who sign up are aware of the gap, and should be prepared.

“My suggestion to people is to stock away a little money each month while you’re not having to pay any co-pays or very low co-pays,” said Gould.

“But I didn’t see four dollar gallon gasoline coming,” said Walder, adding that he was aware of the gap, “I didn’t see getting laid off to part-time work coming.”

Those who do find themselves in trouble can cut costs on prescriptions in other ways, like patient assistant programs that offer discounts and coupons, or Bay Medical Center’s $4 generic medications.

Seniors can also contact Social Security or inquire about the Medigap policy.  Bay County also offers discount cards for residents at any participating pharmacy that saves an average of $8 per prescription.  Walder says staying in touch with his own pharmacists has helped.

“They explained to me this is a better alternative, try this drug, this is a generic alternative, try the four dollar difference,” he said, “and it saved me.”

But, Walder says the next two months without coverage will still be difficult.