On November 15th seniors across the Fourth District will once again be able to sign up for the Medicare prescription drug benefit. Seniors who do not yet have prescription drug coverage should take this opportunity to consider enrolling in the program.
Over 79,000 Medicare beneficiaries are currently receiving prescription drug benefits in Kentucky’s Fourth District. Estimates show that participating seniors are saving an average of $1,100 annually on prescription drug mediations. The average premium for 2006 was $24. The average premium for 2007 is expected to remain the same at $24. That’s 40% lower than initial estimates. In Kentucky there are some plans premiums that are projected to be as low as $18 for 2007. According to a Kaiser Family Foundation poll conducted in July 2006, over 80% of those enrolled in the benefit are satisfied with their coverage.
Nationally, more than 90% of Medicare beneficiaries now have prescription drug coverage. Approximately 29% of beneficiaries have enrolled in a plan that includes a “donut hole”. Plans with “donut holes” provide coverage up to $2,000 in expenses. After reaching this threshold, beneficiaries are responsible for expenses incurred until they reach $3,600. After that point, catastrophic coverage pays for 100% of expenses. PricewaterhouseCoopers estimates that only 8% of beneficiaries who have a plan that includes a “donut hole” will actually reach the coverage gap. If you have a plan with a “donut hole” and are experiencing financial difficulties due to this coverage gap, I encourage you to explore alternative coverage options during this open enrollment season.
The Medicare Prescription Drug Improvement and Modernization Act expressly prohibits the Secretary of Health and Human Services from negotiating the price of prescription drugs on behalf of Medicare beneficiaries. At the time of implementation, the non-partisan Congressional Budget Office (CBO) found that negotiating drug prices would not have an impact on the cost of plan premiums for seniors or federal spending. Reports have indicated that plan premiums, drug costs and federal expenditures have been significantly lower than initial projections. I have written a letter to Comptroller David Walker at the Government Accountability Office (GAO) asking him to investigate whether allowing the government to negotiate drug prices would result in a significant benefit to Medicare beneficiaries and/or a savings for the federal government. As seniors continue to enroll in the prescription drug benefit, we must make decisions about program enhancements and adjustments based on sound economic studies, not political motivations.
For seniors who have not yet enrolled in a plan the Kentucky State Health Insurance Assistance Program (SHIP) is a valuable Medicare resource and can be contacted at (877) 293-7447for information, counseling and assistance. Additionally, please don’t hesitate to contact my office at (859) 426-0080 with questions about Medicare. We will do everything we can to assist you.