HealthLawProf Blog

Editor: Katharine Van Tassel
Akron Univ. School of Law

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Monday, May 23, 2005

Confusion at CMS Over New Medicare Drug Benefit

According to the N.Y. Times, the Bush Administration is revising the 2006 Medicare Handbook due to inaccurate, misleading, or unclear statements in the new benefits guide.  The handbook fails to mention the gap in coverage (the infamous "doughnut hole") and inaccurately emphasizes the private fee-for-service option without clearing distinguishing it from traditional Medicare.  According to the Washington Post, the Medicare prescription drug benefit will costing senior citizens an average of $772 annually, and those with chronic conditions will probably pay double that amount and will have 5 month gaps in coverage.  The gap in coverage may induce many with chronic conditions to forego filling prescriptions, which will have significant negative health implications. However, most Medicare recipients should have some savings. 

The Arizona Republic reports that Medicare recpients that make less than $14,364 a year may be eligible for a subsidy of up to 95% for their premiums and co-pays as long as their assets are not too high.  Generally this low-income subsidy has been seen as very good, however issues such as recipients being ineligible for other federal programs further complicates the decision a Medicare recipient will have to make.

Thanks to research assistant Lindley Bain for her help in preparing this post. [tm]

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