On March 23, 2010 President Barack Obama signed a piece of legislation that enacted the Medicare Part D program which addresses the issue known as the “donut hole”. This legislation is called the Affordable Care Act. Before this legislation was passed much of the elderly population struggled to pay for their prescription medications. The previous system would help the elderly and disabled population pay for their prescription medication to a particular monetary cut off. Once an elderly or disabled person’s prescription medication costs exceeded a certain monetary amount, their provider would no longer assist them in paying for prescription medication. Once a Medicare subscriber exceeded a particular amount of money spent on prescribed medications, their Medicare provider would again help the care subscriber pay for their prescribed medications. This situation is known as the donut hole.
Until the Affordable Care Act many elderly and disabled Medicare subscribers would have to pay for their medication cost completely out of pocket after their medication cost exceeded about $2,840. For those individuals who prescription medication exceeded this amount, they became totally responsible for all expenses. Seniors represent about 34% of the population that is prescribed medication (Rubin, 2010). Prior to the Affordable Car Act many elderly (about 2/5) were not able to correctly take their medications because they could not afford to purchase their prescribed medications or they felt the prescribed medication was not useful (Rubin, 2010). The Medicare Part D program of the Affordable Care Act is a necessary tool to providing affordable and needed care to overlooked populations.
The purpose for the Medicare Part D program of the Affordable Care Act is to assist the elderly and disabled population that fall in the donut hole so that they may afford their prescribed medications without struggling financially. The Medicare Part D program is set up so that after a Medicare subscriber spends more than $2,840 they will be in the donut hole and will remain in the donut hole until they spend more than$4,550 a year on prescribed medications. The major difference with the Medicare Part D program and the medication system is while one is in the donut hole they will receive 50% discount on covered brand name prescribed medications (Bihari, 2010). This 50% discount continues until the total out of pocket cost reaches $4,550.
The Medicare Part D program of the Affordable Care Act is very important to help the elderly and disabled population receive the prescribed medications they need to live a healthy life. According to the Kaiser Family Foundation, financing the Medicare Part D program of the Affordable Care Act will be about $55 billion in 2011 (Kaiser, 2010). The financing for this Medicare spending is estimated to come from general revenues (82%), beneficiary premiums (10%), and state contributions (7%), according to the Kaiser Family Foundation (Kaiser, 2010).
Medicare Part D is a program from the Affordable Care Act and the goal of this program is to make prescribed medications more affordable to the elderly and disabled on Medicare. According to the Kaiser Family Foundation, “Closing the coverage gap by 2020 is expected to bring additional relief to millions of enrollees” (Kaiser, 2010).
References
Bihari, M. (2010, November 23). Medicare Part D Donut Hole- Understanding the Medicare Part
D Donut Hole. Welcome to Health Insurance at About.com. Retrieved March 28, 2011, from http://healthinsurance.about.com/od/medicare/a/understanding_part_d.htm?p=1
Kaiser Family Foundation. (2010, October 20). The Medicare Prescription Drug Benefit. The
Henry J, Kaiser Family Foundation. Retrieved March 28, 2011, from http://www.kff.org/medicare/upload/7044-11.pdf
Rubin, A. & Rubin, H. (2010, August 27). Prescription Drugs and the Elderly. The Rubins.
Retrieved March 28, 2011, from http://therubins.com/geninfo/eldpresc.htm
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