Does this really close the doughnut hole?

AARP was really pulling for this crazy health insurance bill to pass because they have a vested interest in United Health Care's Medicare supplement insurance.  And in case you were not aware, United is in part owned by one of the Big PhRMA firm poised to make big bucks on the recently passed bill,

What the real facts are that the doughnut hole is not closed, it is only reduced in diameter.

Prescription Drugs:

Proponents of the health care bill have been touting how it aims to close the "doughnut hole" in prescription drug coverage. What that means is that older Americans who hit the cap on their Medicare prescription drug benefits will be given a rebate, starting this year. Once they spend $2,830, older Americans will receive a $250 rebate. Starting in 2011, older Americans who go past the allotted amount will be given a 50 percent discount on prescription drugs. The bill aims to close the "doughnut hole" completely by 2020, but older Americans will still have to pay for 25 percent of their drugs.

SOURCE

More from Kiplinger -

Health Care Reform: What It Means for Retirees

Changes to Medicare and to the individual insurance market will affect retirees. Here are key details that you need to know.
By Susan B. Garland, March 24, 2010

President Obama has signed the landmark health-care overhaul legislation into law, and the Senate is taking up a bill with proposed changes. Here are key provisions that could affect you.
Medicare. The Part D prescription-drug doughnut hole will be gradually reduced by 2020. Seniors who reach the doughnut hole in 2010 will receive a $250 rebate. Starting in 2011, drug companies will be required to provide a 50% discount on brand-name drugs bought in the coverage gap. The federal subsidy for Part D premiums will be reduced for higher-income beneficiaries. Cost sharing for preventive-care services is eliminated.
A new advisory board would submit recommendations to Congress to reduce the rate of growth in Medicare spending. The board is not allowed to submit proposals that would ration care or change benefits.
More Medicare beneficiaries could be snared by the Part B premium surcharge for high-income seniors. The law freezes the income thresholds for income-related Part B premiums from 2011 to 2019.
Medicare Advantage plans. Studies have found that Advantage plans cost the government 14% more on average than traditional Medicare. To get costs more in line with traditional Medicare, the new law freezes federal payments to private Medicare Advantage plans at 2010 levels. These plans will be required to spend at least 85% of their revenues on patient care. Plans that prove they provide high-quality efficient care will get rebates from the government.
New taxes. The law would raise the Medicare payroll tax by an additional 0.9% (to 2.35%, from the current 1.45%) on earned income above $200,000 for individuals and $250,000 for joint filers. It would also impose a Medicare tax of 3.8% on investment income, such as dividends and interest, for individuals with adjusted gross income above $200,000 and joint filers with AGI above $250,000. These taxes will go into effect in 2013. Distributions from pensions, IRAs, 401(k)s and other qualified retirement plans will be exempt. Self-employed people will have to pay the additional tax.
Medical tax deductions. Beginning in the 2013 tax year, the threshold for the itemized medical deduction rises to 10% of AGI, from the current 7.5%. Individuals age 65 and older, and their spouses, would be exempt for the tax years 2013 through 2016.
Early retirees and self-employed. For most workers who receive employer-sponsored coverage, the new law is not likely to have much impact. But the law provides a number of protections for those who need to buy insurance in the individual market. Six months after enactment, health insurers cannot place lifetime limits on the value of coverage or revoke existing coverage. Starting in 2014, insurers must accept all applicants, including anyone with preexisting medical conditions.
Until then, individuals with preexisting conditions who have been uninsured for more than six months will be eligible to enroll in a national high-risk pool and receive subsidized premiums. Cost sharing will be capped at $5,950 for individuals and $11,900 for families. This could be especially helpful to early retirees in Arizona and Nevada, which do not have state high-risk pools. It could also help Floridians, because Florida's is not open to new enrollees.
Exchanges and coverage subsidies. Nearly everyone would be required to buy coverage, or pay a penalty. Early retirees, the self-employed and others without insurance would be able to purchase coverage through state-based exchanges. Tax credits would be available to individuals and families with income between 133% and 400% of the poverty level (that's $19,378 to $58,280 for a couple).
Private insurance companies could sell policies through the exchanges. Buyers would choose among four benefit categories.
Retiree health plans. If you are 55 or older and receive retiree health benefits from your employer, you could benefit from a government reinsurance program. The program will reimburse employers or insurers for 80% of retiree claims between $15,000 and $90,000. Payments from the reinsurance program will be used to lower the costs for enrollees in the employer plan. The program will end on January 1, 2014. It will not reimburse costs for retirees who are eligible for Medicare.
Long-term care. In 2011, workers can enroll in a national insurance program to cover non-medical services in case of disability. After a five-year vesting period, the Community Living Assistance Services and Supports program will provide individuals who become disabled with a benefit of about $50 a day. The program will be financed with voluntary payroll deductions.
For more authoritative guidance on retirement investing, slashing taxes and getting the best health care, click here for a FREE sample issue of Kiplinger’s Retirement Report.

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http://www.kiplinger.com/features/archives/krr-health-care-reform-what-it-means-for-retirees.html

The Medicare donut hole: Now you're covered, now you're not

ScienceDaily (2010-03-25) -- If you're older, a woman, and suffering from either dementia or diabetes, you are the most likely to be exposed to unsubsidized medication costs in the US. This is known as the coverage gap for enrollees of Medicare Part D. According to a new study, these clinically vulnerable groups should be counseled on how to best manage costs through either drug substitution or discontinuation of specific, non-essential medications. ... > read full article

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Posted in: Doughnut hole,health insurance reform

Lawmakers have wooed seniors into the hole

Readers should not that Obama made a deal with Big PhRMA to reduct the donut hole, not to close it.  What needs to happen is for the Plan D to be eliminated and go back to co-pay along with price negotitation.  As long as Obama is bought off by Big PhRMA there will never bee price negotiation in Medicare.

All this political nonsense harms people who have been made captives through drug advertising and doctor pay-offs to Rx specific drugs.  And for a minute, don't forget AARP sold out Seniors on this drug plan and are doing the same in health reform because they have to much to lose in their close deal with United.

Why not give this woman supplements that we know help memory issues and cover these?  Sure would save a million or much more on health costs and would not require Big Ins demands for lower medicare reimbursement.

It's a racket Magee!  Don't ya see?

Note too that some drug companies want the sales of their drugs so badly they will help you cover the costs.

'Doughnut hole' unites seniors wary of health bill

By MATT SEDENSKY, Associated Press Writer
Fri Dec 4,

MIAMI – Lawmakers have wooed seniors skeptical of the health care overhaul by emphasizing the plan would close the "doughnut hole" — a gap in Medicare drug coverage that can cost thousands of dollars a year.

But getting support for the entire overhaul from this powerful voting bloc has been difficult, despite Democrats' repeated mentions of the issue in town hall meetings, interviews and congressional hearings.

Janet Cohen, 75, would like to see the doughnut hole closed, but like many, she still is uncertain about the health bills.

Cohen and her 97-year-old mother are both in the doughnut hole because their out-of-pocket drug costs exceeded $2,700 this year. Rather than just a copay, each one now must foot the entire cost of their medications for the rest of the year, or until their annual spending reaches $4,350, which isn't likely to happen. If it does, the government will again subsidize the costs.

The Cohens, who live just north of Miami, are both on Social Security and eating through savings. Janet Cohen just learned she was in the doughnut hole when she went to pick up her supply of Aricept, which she takes for memory loss. Instead of the copay, she was charged nearly $200.

"I can't afford my medicine, is it OK if I miss like one month?" she asked the pharmacist.

He suggested taking the drug every other day, but said the effectiveness could be compromised.

Medicare Part D established a new prescription drug benefit in 2006. The doughnut hole was designed to reduce the overall cost of the program. An estimated 3.4 million seniors fall into it each year.

Most people never see the other side of the doughnut hole. They simply wait for New Year's Day. The House health care bill would close the gap gradually until it's eliminated in 2022.

There are about 39 million people aged 65 and older in the U.S. and they voted at a higher rate than any other age group in the 2008 election, according to the Census Bureau. The 40-million-member AARP has endorsed the House's version of the bill, but voters aren't yet sold on the plan.
The latest Kaiser Health Tracking Poll, released last month, found just 32 percent of those 65 and older believed passage of a health bill would leave them and their families better off, compared with 44 percent of respondents under the age of 65.

When asked about elements of the health overhaul plan that are "extremely" or "very" important, the doughnut hole was the No. 3 issue for Republicans, and No. 4 for both Democrats and independents.

Rep. Kathy Castor, D-Fla., saw a summer town hall meeting become a shouting match. In subsequent visits to senior centers, constituents expressed worry their Medicare costs would increase or that they would no longer be able to see their doctors.

The doughnut hole, she said, has helped garner support for the overhaul.

"It's easily understood that eliminating the Part D doughnut hole will put cash back into the pockets of seniors who need it desperately," she said.

Some will grovel to avoid the doughnut hole. Maida Genser meticulously keeps track of her 72-year-old husband Morton's drug costs, trying to determine when he'll hit the threshold for his numerous pills to control diabetes, blood pressure and other problems.
As the limit approached in October, 66-year-old Maida had a strategy: "I just kept begging different doctors for samples."

Others aren't sure what to do. Evodkia Kresch, 83, takes pills for glaucoma, diabetes and heart problems and has been in the doughnut hole for several months. She grew up in Ukraine and lost her parents and six siblings in the Holocaust. Her husband died two years ago and she lives off a Social Security check of about $1,300 a month. She doesn't have much hope things will change in Washington.

"They talk, they talk," she said. "But I need to live. And they just talk."

A recent round of refills cost her $412. She paid for them with her meager savings.

"I never asked the government for a penny. I came and I worked every day and I don't know what to do," she said, slipping into a soft sob. "It's terrible. I don't know what to do. I come back and I cry."

http://news.yahoo.com/s/ap/20091204/ap_on_bi_ge/us_health_overhaul_prescription_drugs/print

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Posted in: Doughnut hole,health reform