Subscribe to ePluribus Media



ePluribus Media Store


Want Headlines via Email?
Enter your email address:


Help Save 1.800.SUICIDE


Part D Donut Hole Is Hitting NOW For Some!

by rcs1

originally posted Sun May 21, 2006 at 02:01:39 AM EST -- bumped

Frank Furfaro of Patchogue, N.Y. had drug coverage through his Medicare managed-care plan. The, his plan adopted Part D and everything changed. His premiums increased and the plan covered fewer of the drugs he took.

Furfaro who previously had a heart-transplant, discovered he'd hit the doughnut hole (coverage gap) last month after getting refills for immunosuppressants. medications. The pharmacist charged him $661 and $329 for the prescriptions, instead of his co-pays.

Furfaro wasn't told about the doughnut hole when his coverage changed in January.

"I threw a fit.  What am I supposed to do? I don't have $661 in my pocket.  I thought, `That's it. It's over.' The three years I put into the transplant, the waiting and everything. It was a waste of time because I can't get my medicine."

commentary :: :: :: buzz-it!
His father purchased the cheaper drug of the two.  However, Furfaro has gone more than three weeks without a prescription to prevent severe organ rejection and has been receiving Social Seurity Disabiity. Despite that, he recently took a position as a security guard to pay for his prescritptions

Furfaro is having health problems.  

"I lay around a lot. I don't have a lot of energy. I'm short of breath. I don't feel well at all."

If his health contnues to deteriorate, he'll be admitted to the hospital to receive his medicine. Medicare will pay all bills for a hospitalization.

Robert Hayes of the Medicare Rights Center:

"Millions of people and millions more family members are going to be experiencing this shocking and crushing problem.  That's what happens when people can't get the basic care they need. And medicine is basic care."
 Hayes also added that he expects that scenario to occur repeatedly across the country.

If Congress had premitted Medicare to negotiate for the best price of prescriptions, the savings would allow for prescription coverage with no interruptions.  Another problem is the insistence on the donut hole in the Part D legislation.

Juliette Cubanski, of the Kaiser Family Foundation,

"[The donut hole] is not something we've ever seen in any other insurance product that I'm aware of."

On Sept. 5, 2003, Sen. John R. McCain (R-Ariz.) told the New York Times, "There's no doubt in my mind that the drug industry got everything it wanted and more," he said. "It perhaps should be called the 'Leave-No-Lobbyist-Behind Bill.'

Display:
at the Orange place and others.

by Terri Emerick on Sun May 21, 2006 at 02:04:18 AM EST
This is a terrible situation for someone to be placed in and I doubt a transplant patient needs any additional stress.  For those who may not be familiar with the "donut hole" ....


  1. Beneficiaries have to pay the first $250 as a deductible each year.

  2. Medicare will pay 75% of costs between $250-$2,250 worth of drugs on their plan's formulary or list of prescription drugs the private plan covers.

  3. Once this initial payment cap is reached, most people will have a gap in coverage, known as the "donut hole". In other words, beneficiaries will be responsible for all drug costs between $2,250 and $5,100.

  4. Upon passing the "donut hole", Medicare will begin paying about 95% of the cost of covered drugs until the end of the calendar year. The "donut hole" will result in people having to pay $3,600 for their medications if they have high medical needs.

  5. The monthly premium must still be paid during the "donut hole".

Source:  FairMedicare.org


by standingup on Sun May 21, 2006 at 09:28:11 PM EST
It is a terrible situation for anyone to be in.  On some of the other sites that I have posted on, there  are people who dread going to the pharmacy, or to check their mail, have had it w/attempting to interpret the medicare.gov site, and are totally stressed out about the whole thing.  Part D is a nightmare, and as you said, a transplant patient in particular does not need this kind of stress.

I can't even imagine going thru all of that the gentleman in the article that I linked to did.  No one can. It makes me furious to even think that elected officials can treat people like that.

And I really feel sorry for those that do.  But, as Robert Hayes said, this is going to be repeated unless Part D is changed FAST!

That donut hole has to go!

by Terri Emerick on Sun May 21, 2006 at 09:54:56 PM EST
[ Parent ]

Great site!

by Terri Emerick on Sun May 21, 2006 at 09:56:11 PM EST
[ Parent ]

Support ePluribus Media -- Support Citizen Powered Journalism!

ePluribus Media

↑ Grab this Headline Animator

members


community front page

make a new account


Username:
Password:

create account | faq | search | community front page |