Drug plan may confuse some
Lynchburg News and Advance
Tuesday, November 1, 2005The new Medicare Drug Benefit is opening up the MedsHelp roster for low-income younger clients needing access to free prescription drugs, but it may represent an abrupt change for older patients. MedsHelp, the pharmacy program located at the Free Clinic of Central Virginia, 1016 Main St., Lynchburg, will lose about 80 percent of its pharmacy patients as of Jan. 1, said Shannon Jarvis, MedsHelp coordinator.
“About 80 percent of my patients are Medicare eligible,” she said. “That’s going to leave a big opening.”
Medicare is the federal insurance for people age 65 and older and some younger people with disabilities.
MedsHelp will continue to help uninsured adults and under-insured children within 150 to 175 percent of the federal poverty level.
Once the Medicare D goes into effect, most drug companies involved in the Indigent Drug programs will stop serving Medicare eligible patients, said Jarvis.
It’s going to be a change for many of them, said Jarvis.
Some have been clients for five or six years, and now are facing the changes brought on by the Medicare Modernization Act of 2003, which goes into effect in January.
Right now MedsHelp has a fee of $25 for every six months to help people obtain free prescription drugs - $50 a year.
But when Medicare D goes into effect many of MedsHelp patients will pay a monthly fee through an insurance plan for their drugs, she said. They will pay from $8 to $64 a month depending on the plan selected, plus a $250 deductible and co-pay.
The co-pay will likely be $1 to $3. Some take as many as 20 different medications, she said. And only a month’s supply of drugs can be ordered, said Jarvis, as compared to the three months now available through the prescription drug program for the indigent.
Plan selection begins Nov. 15.
Jarvis is concerned that the Medicare Drug benefit will be confusing for older people who have to select among many plans.
Small 10-person sessions are being set up for MedsHelp clients age 64 and older to help them select a plan that will meet their needs, said Jarvis. Part of that is using a computer system to find which plan will offer the prescriptions the person needs.
“A lot of the plans will not offer every drug the patients are on,” she said. And they will have to use the Medicare appeals system to get the needed drug covered by their plan.
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