NYT: New Medicare Plan Presents a Drug Benefit Conundrum

New Medicare Plan Presents a Drug Benefit Conundrum
By MILT FREUDENHEIM and ROBERT PEAR
Published: November 4, 2005


Louis A. deBottari, a 78-year-old retired aerospace worker with ample drug coverage in his health plan, recently opened an envelope from Boeing, hoping to be reassured.

The notice, sent to about 100,000 Boeing retirees and their dependents, discussed the new Medicare drug insurance program that begins in January and what it means for retirees already covered by the company's health plan.

"In general," Mr. deBottari read, "your Boeing prescription drug coverage is more generous than standard Medicare prescription drug coverage." So far, so good.

But a bit farther down came a warning, if Mr. deBottari was nonetheless tempted to give the new Medicare program, called Part D, a try: "Your Boeing prescription drug coverage is part of your Boeing retiree medical plan. If you cancel your Boeing prescription drug coverage, your Boeing medical coverage also will be canceled."

Many other retirees fortunate enough to already have drug coverage are receiving similar warnings from their former employers as the new Medicare drug benefit approaches....


http://www.nytimes.com/2005/11/04/business/04retiree.html?oref=login

to do this--drop the coverage. Another plan gone amuck.

I am over 70 so should sign up, they say. It will cost me a monthly fee to do this and they will help if my drug bill goes over .I think. 2000 a year. Now I take no pills and Maine will help me pay when I do so to hell with paying monthly and hope I pay over 2000 a year on pills. I bet I will get some wild letters soon on joining this rape of the people for drug companies. I am so sick of this group in DC. :dilemma:

The coverage kicks in before $2000 in purchases. You have a $250 deductible then the plan pays 75% of the cost. There is that donut hole though that kicks in after $2800 or so in bills. You have zero coverage during that phase of the design.

Here's the answer to what's going on with the incentives, from further down in the article:

There is another factor. Like other employers who continue offering drug insurance as good as or better than Medicare's, Boeing will receive a federal subsidy for the drug purchases of each retiree it retains. Many of those companies have shown little interest in continuing to provide other, increasingly expensive health coverage to a retiree if they lose the drug subsidy.

The whole program is a total boondoggle.

Straight Social Security (for those over 62), are recipients under the income level making them eligble for substantial Drug discounts under the new Part D (at least as I read it). And those who have a spouse are able to have a higher income level, and still get decent Drug benefits.

But for SSDI recipients, who often fall about $1,000 PER YEAR over the maximum income level, FAIL to qualify for discounts under "Part "D" UNTIL they spend more than $3,500 on prescription drugs, then the "catastrophic benefit discounts" begin. Until then they pay approx. 80-90% of Retail drug prices. For people on essentially Poverty Level income (except for perhaps $1,000/yr.)... and much in need of pharmaceutical drugs, the fact that they have to spend out-of-pocket over $3,000/yr. in order to BEGIN qualifying for substantial drug discounts is absurd, and inhumane.

And now the Admin. is talking of "cutting Medicare?" How much more can they cut? I shudder to think how much. Knowing their "track record," that "cut" means..."to shreds."

Straight Social Security (for those over 62), are recipients under the income level making them eligble for substantial Drug discounts under the new Part D (at least as I read it). And those who have a spouse are able to have a higher income level, and still get decent Drug benefits.

But for SSDI recipients, who often fall about $1,000 PER YEAR over the maximum income level, FAIL to qualify for discounts under "Part "D" UNTIL they spend more than $3,500 on prescription drugs, then the "catastrophic benefit discounts" begin. Until then they pay approx. 80-90% of Retail drug prices. For people on essentially Poverty Level income (except for perhaps $1,000/yr.)... and much in need of pharmaceutical drugs, the fact that they have to spend out-of-pocket over $3,000/yr. in order to BEGIN qualifying for substantial drug discounts is absurd, and inhumane.

And now the Admin. is talking of "cutting Medicare?" How much more can they cut? I shudder to think how much. Knowing their "track record," that "cut" means..."to shreds."

people on SSDI currently have (or are eligible for) Medicaid. Under the drug plan, they will be responsible for 5% of their drugs -- that's all.

However, they must sign up for the enhanced coverage (due to income level), but it is done automatically if they were enrolled in Medicaid.

Companies canceling their retiree's medical care, drug benefits, etc. is beginning to run rampant. It's the latest, greatest fad to cut the bottom line. Therefore, seniors like the one described in the article better seriously join in fighting for healthcare for all age levels in this nation because they will live to see their 'benefits' jerked out from under them. In fact, many of them are what keeps the repukes thinking they can destroy medicare, SS, etc. and still have support. These people need to start thinking an acting as though they are going to have to 100% depend on Medicare because that's exactly where they are going to be dumped in the not to distance future.

This whole Medicare Part D thing is really confusing to everyone I think. I've read there are a lot of options and it all depends on your needs. Here is a good link to the aarp webpage that might help you understand things a little better...it helped me at least.

http://www.aarp.org/health/medicare/drug_coverage/medicarerx_coverage.html