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Wednesday, September 12, 2012

Coverage For Prescriptions

By Elizabeth Waters


Average basic premiums for Medicare prescription drug plans are expected to remain steady throughout 2013. The average 2013 out of pocket monthly premium for basic prescription drug coverage is expected to be approximately $30. The projections are based on bids submitted by drug and health plans for basic coverage during the 2013 benefit year, and calculated by the Centers for Medicare and Medicaid services (CMS). While the average premiums for 2012 were projected at the same rate ($30) actual numbers were encouraging, averaging slightly less at $29.67. Millions of Medicare recipients are saving an average of over $600 each year on their prescription drugs. This savings can be substantial to individuals living at or below poverty level.

Seniors with disabilities are the citizens who are most affected by out of pocket prescription expenses. Fortunately they will benefit greatly from the Affordable Care Act's efforts in correcting the coverage gap. This initiative has already made great strides towards narrowing and eliminating the "donut hole" coverage gap. Seniors and people with disabilities are now saving $3.9 billion on prescription drugs. As the Affordable Care Act progresses the coverage gap will lesson and will eventually be nonexistent.

This new enactment allows people with Medicare the opportunity to compare their current coverage and quality ratings to other plans now available to them for the next year. Information and assistance is available to those individuals who may need help in understanding the best choice for their needs. The enrollment period begins Oct. 15 2012 and ends Dec. 7, 2012 with the new benefit choices becoming effective Jan. 1, 2013.

Thanks to the Affordable Care Act, out-of-pocket savings on medications for people with Medicare continue to grow. Last month, The Centers for Medicare and Medicaid (CMS) announced that more than 5.2 million people who fall in the Medicare Part D "donut hole" have already benefitted from premium reductions since the law was enacted. The average savings thus far is $629 per person this year alone. For the populations who subsist on the minimum level of Social Security benefits this savings is significant.

As a result of the Affordable Care Act, the costs for both brand name and generic prescription drugs in the coverage gap will continue to decrease over time. By the year 2020, the coverage gap will be abolished and the "donut hole" will no longer be an issue. This will be a momentous achievement in the movement towards reform of the American Healthcare System.




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