Moore-Rowe says Medicare Part D has helped her in many ways, but she says other people aren't so fortunate.
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Medicare Part D Recipient: Beverly Moore-Rowe: My coverage is through my Medicare and through the prescription plan. Because of my low income, my bills have so far been okay, but I am also looking at my mother and my husband. My husband is 81 and he has just following through the Medicare Doughnut Hole or the gap. Right now, since he is following through the gap, his medication is just for the primary ones, the really big expensive ones are running in the $425 a month in that range, which puts it out of our range to be able to pay for all of that. In fact when we were looking at getting insurance, getting the prescription plan for my husband, we were told that we have to get, we have to sign up, and my husband already had Blue Cross Blue Shield that he had a policy that would cover a lot of his medications that will keep the medication cost down. Her monthly healthcare cost: Beverly Moore-Rowe: It depends on if I go to the doctor, I will try to avoid going to the doctor as much as I can. It's not always in your best interest to not go, but the other side of it is, that you know you're going to have huge medical bill as you kind of avoid that. The Medicare Part D Coverage Gap: At about $2,500, patients have to pay 100% of their prescription drug costs until they've spent a set amount of out-of-pocket money. Beverly Moore-Rowe: And my research said that once you fall into the gap, it usually is between 3,600 and 3,800 that the gap hits. Once that hits, you have to pay 100% of whatever the cost of your medicines are. So if you're taking a medicine that's of $1,000, you have to pay that $1000 out-of-pocket. And if you consider, let's say a medicine is costing $300. Well, if it's $300 a month, every month, that's a difference between being able to afford to buy your groceries, being able to pay your long-term care insurance to ensure that when you have to go into a skilled nursing facility that you have the funding to do that or to at least help you through that process. Say, the gap is not a problem so much if you're on the lower price medicines. But if you're on medication and I am going to use Aricept as an example, that's a one drug that there is no other drug like it. It's the only one that you can get. So if you're on Aricept, you pay the full amount of the cost of Aricept for a month and a month supply is over $100. Changes she would like to see: Beverly Moore-Rowe: Well, I'd like to see something done and I don't have a solution for the problem. I don't see one unless they can force the drug companies to reduce their expectations of profits. That's the big thing that I see. The other possibility I could see is if the government would develop a program for being able to purchase medications and sell them to the people at a lower price. Purchase in huge bulks so that they can sell them at a lower price, or they could develop some sort of medical assistance program where the uninsured or the under-insured could get some sort of benefits that were with the assistance.