Posted by webmaster in General Medicare Information, Medicare News

The Daily Press has an article that helps explain the often confusing Medicare Drug Plan. Some important quotes from the article are below:

In January 2006, Medicare began offering prescription drug coverage to all beneficiaries. The creation of this program led to an increase in the number of elderly and disabled Virginians who have drug coverage. In 2005, 570,220 or 58.7 percent of all Virginia’s Medicare beneficiaries had comprehensive prescription drug coverage, most often through Medicaid or through a previous employer. In 2006, with the inception of the Medicare prescription drug benefit, the number of Virginia’s beneficiaries with comprehensive prescription drug coverage rose to 924,616. More than 90 percent of all Medicare recipients in Virginia now have comprehensive prescription drug coverage, according to the Centers for Medicare & Medicaid Services (CMS).

The coverage gap is a part of some Medicare prescription drug plans, but it is not a part of all plans and does not affect all who have enrolled in a plan. Many beneficiaries do not realize that they are likely a part of the 92 percent of all Medicare beneficiaries who will not be subject to the gap at all because:

1.  They are in a plan that provides gap coverage;
2. They are receiving a subsidy that eliminates the gap; 
3. They have drug coverage other than through Medicare; or
4. They do not spend enough on prescription drugs to reach the gap in the first place.

The Daily Press notes that patients who do have a gap are still going to pay less for their prescriptions than a general cash paying customer, and that patients in the gap have the option to change to an insurance plan that covers the gap during their next enrollment period (November 15th to December 31, 2006). Seniors who can not afford the gap-covered insurance plans are encouraged to investigate low-income subsidies to eliminate the gap.