The Medicare Prescription Drug Program: Working for Seniors
By Larry Lucas, Deputy Vice President
Pharmaceutical Research and Manufacturers of America
The Medicare Prescription Drug Program, known as Part D, is helping
seniors and disabled Americans get the prescription medications
they need to live healthier, longer lives.
While Part D has been in effect for just over one year, already
90 percent of America’s seniors are benefiting from comprehensive
prescription drug coverage, according to government reports. This
is nearly twice as many Americans as were covered just a few short
Beneficiaries also have experienced significant savings on their
prescription medicines. On average, seniors are saving $1,200
a year, according to the Centers for Medicare and Medicaid Services
(CMS). Last year, the average monthly premium was $23 –
and it is expected to be $22 in 2007 – about one third less
than the $37 that was originally projected, CMS reports.
What’s more, seniors enrolled in a Medicare drug plan can
decide – in consultation with their doctors – which
medicines are best for them. Medicare does not prescribe a one-size-fits-all
plan, but instead allows beneficiaries to pick the plan that best
meets their individual needs and health conditions.
Part D has brought comprehensive prescription drug coverage and
peace of mind to millions of America’s seniors and disabled.
However, there are millions more who can benefit from the program
– and many are eligible for “extra help” from
Low-income subsidies are available to those who cannot afford
Part D plan, making it possible for all seniors to receive the
medicines they need. Beneficiaries who meet the income and assets
requirements can receive additional help from the government to
pay monthly premiums and annual deductibles as well as little
to no co-payments. In addition, these “extra help”
recipients do not face a coverage gap (or “doughnut hole”)
in their prescription drug plan, meaning their medication will
be covered all year without interruption.
While the general open-enrollment period for 2007 coverage ended
on December 31, seniors who meet the low-income subsidy requirements
can sign up at any time this year with no penalty.
Last year, government health officials estimated that just over
three million Americans were eligible for the low-income subsidy,
but had yet to apply. If you have not signed up for a Medicare
drug plan because of financial concerns, I urge you to look into
possible help through the subsidy program. Seniors and disabled
Americans can learn more by visiting their local Social Security
office or calling 1-800-772-1213.
Medicare Part D also has brought the Medicare program into the
21st Century by focusing on prevention. With prescription medications
now covered under Medicare, the emphasis has shifted from treating
patients once they are sick to helping patients keep healthy.
This preventive model is part of modern medicine’s comprehensive
approach to health care, which often includes prescription medications,
particularly for seniors.
This is especially important for those with chronic conditions
like diabetes and hypertension – which, if managed with
medication and appropriate lifestyle modifications, can be controlled.
Without treatment, such illnesses can lead to heart disease, stroke,
In addition to comprehensive prescription drug coverage, Medicare
Part D provides an array of screening services aimed at disease
prevention. Seniors enrolled in a Part D plan are eligible to
receive a “Welcome to Medicare” physical exam, as
well as periodic screening tests for cardiovascular conditions,
colorectal cancer, prostate cancer, diabetes, pap tests, mammograms
and more. Part D also covers bone mass measurements for people
at risk for osteoporosis, glaucoma tests and flu shots.
What’s more, Medicare drug plans also are required to provide
beneficiaries with chronic conditions additional assistance in
managing their prescription drugs. Medication therapy management
programs differ by plan, but can include counseling to discuss
complex treatment regimens, help with medication compliance and
other patient education services.
I can’t emphasize enough the importance of Medicare Part
D for all seniors, especially those in the African-American community,
who suffer disproportionately from certain chronic conditions
like hypertension and diabetes.
For help, contact a Medicare counselor at 1-800-MEDICARE, or
They can help find the best plan for you and determine whether
you qualify for a low-income subsidy.