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Millions of seniors and people with disabilities who depend on Part D for prescription coverage will hit the “donut hole”. The donut hole is a gap in coverage. Prescriptions are paid for until the amount of $2250 for the cost of the prescriptions is reached.

According to CMS, if a drug costs $150 and the beneficiary‚Äôs co-payment is $40, the full $150 is calculated toward the “donut hole”/coverage gap.

During the time period that a person is in the “donut hole”, he/she is also responsible for the payments on the policy, in addition to the costs for prescriptions until the amount of $5100.00 is paid. This results with $2850.00 that must be paid by a person who is on a fixed income.  Millions of people who aren’t aware of the donut hole or its severity will be unable to afford their prescriptions.

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In response to the unfair restrictions re: Part D, specifically, the closing of enrollment and the “donut hole”/coverage gap, a group of seniors went to Congressman Ray LaHood’s office Thursday with empty pill bottles, symbolizing the thousands of prescriptions that will go unfilled because of both.

In addition, the Illinois Alliance for Retired Americans wrote a letter to Congressman LaHood, requesting the deadline be changed.

Nancy Gardner, of the Illinois Association of Retired Persons:

“The penalty of one percent of a month means that by the end of this year they were going to have a 7 percent penalty.  That’s what they would have and, not only that, but they aren’t going to be able to get their drugs filled between now and then. They’re not going to have any insurance and a lot of them are the ones that need it the most, the ones that can’t understand it are the ones that need it the most.”

LaHood was unavailable, but a member of his staff did listen to the group’s concerns.

In addition, a second group, Citizen’s Action Council, echoed their concerns.

Third, Americans United announced will hold 18 ‘Fix Part D Hearings’ in 14 states. Members of Congress and their staff will receive testimony from seniors, the disabled, and other experts on Part D. Real ways to fix it will be offerred. Americans United, along with state affiliates of national partner USAction, will also show video produced by the national health care consumers group Families USA.  

The video is titled “The Problems with the Medicare Drug Program – and How to Fix Them”.  It will be narrated by Walter Cronkite.   Members of Congress will be asked for their support on Americans United’s plan to fix to Part D, which is briefly explained below.

       Americans United Plan to Fix Part D

  •      Reduce the cost of prescription drugs by requiring Medicare to negotiate lower prices from drug companies,
  •      Close the “donut hole” referring to the gap in coverage for annual costs between two thousand two hundred fifty dollars and five thousand one hundred dollars which will result in millions of seniors being denied coverage each year while they still pay monthly premiums
  •      Allow seniors the choice of obtaining their prescription drug plan directly from Medicare–instead of from a private insurance company.
  •      Prohibit insurance companies from dropping drugs after a plan stats if people are prohibited from switching plans
  •      Re-open Part D enrollment and waive the late enrollment penalty until Part D is fixed.

Jeremy Funk, spokesman for Americans United:  

“It’s important that Congress hear concerns directly from their senior and disabled constituents who have either been locked out of the Part D program until next year with no coverage and those who will soon find themselves within the program’s massive coverage gap while still paying costly monthly premiums.  They need to hear first hand from people hurt by the costly and corrupt nature of the program and they need to support meaningful fixes to make it simple, affordable and guaranteed.  Part D was written by and for the special interests.  There’s no other reason why Medicare would be prohibited from negotiating lower prices with the drug companies.  There’s no other reason why seniors are forbidden from getting a drug plan directly through Medicare. There’s no other reason why the private insurance plans are allowed to drop coverage for specific drugs at any time while seniors are locked into their plans.”

Fix Part D Hearings’ Schedule

AZ  6/1  5:00 PM Speakers: Nick Nyhart – Executive Director of Public Campaign

Hope Hall, Grace Lutheran Church, 1124 N 3rd St, Phoenix

CT New Briton

FL 6/1 2:30pm, Palm Harbor Community Center, 1500 16th St., Palm Harbor

IA 6/20 1:00 PM, Waterloo Public Library,Waterloo

IN  6/5 10:00am
Town Hall
North United Methodist Church, 38th and Meridian Streets, Indianapolis

6/8 10:00 am
Town Hall
The League for the Blind and Disabled
5821 S. Anthony Blvd.
Fort Wayne

MD Longbranch Senior Center, Silver Spring

ME 5/31, 10:00 am, Hammond Street Senior Center, Bangor

MN 5/31, 10:00 am, Senate Hearing Room 112, MN State Capitol, St. Paul

MO 5/31, 1:00 pm, Palestin Senior Activity Center
3325 Prospect, Kansas City

6/1, 7:30 PM, Daniel Boone Library – Friends Room,
100 W. Broadway, Columbia

6/1, 11:00 am, Ferguson Municipal Public Library
35 North Florissant Road, St. Louis

NY, 7/10 Saratoga Springs

PA 6/1, 1:30pm, Pennwood Library, 301 S Pine Street, Langhorne

6/2, 1:30pm, Chester County Library – Struble Room
450 Exton Square Parkway, Exton

WA  6/10, 12:00 PM, Part of White House Conference on Aging
Seattle Labor Temple – Main Hall, 2800 First Ave.

WI  6/2, Paper Valley Hotel, 333 W College Ave, Appleton

WV  5/31,  3:00 PM  Panel:
State Rep Don Perdue – Chair of House Heath & Human Resources
Larry Matheney – WV AFL-CIO Sec/Treasurer
Gary Zuckett – WVCAG

Cross Lanes Unity Apts, 101 Unity Lane, Cross Lanes

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