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Toby Laping Associates www.WNYCareManager.com
Eldercare News |
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You Need To Know . . . Prescription Drugs - Until Congress Decides by Toby F. Laping, Ph.D., C.S.W. Without my crystal ball, I can’t even guess what Congress will do with the providing coverage for prescription drugs under Medicare. It doesn’t look as though the unformed plan that Bush proposed in his State of the Union address is likely to go far. Democrats have objected to any plan that connects Medicare coverage for drugs with the need for HMO membership because that would force seniors to choose between Medicare as we know it and managed care with coverage for drugs. Although it’s unclear, that seems to be a factor in this administration’s concept. Even some Republicans are now saying that they are not in support of this still poorly defined plan. Charles Grassley (R, Iowa) has said that prescription drug coverage must be available to all seniors and not just those who switch into managed care. Medicare beneficiaries who have not joined HMOs but who want prescription coverage have a hard time finding adequate coverage at an affordable price. Some Medi-gap policies have medication coverage but even that is expensive and it’s often inadequate. So, a lucky few have good insurance that covers their medicines. Other people go to Canada for drugs. And, the rest of us worry and complain to friends, and we write our representatives in Congress. And, Congress argues. And, not much happens. All of us should be writing the folks in Washington who need to address this. We may not all feel the same way but this issue of the cost of prescriptions and of health insurance affects all of us; our legislators need to act in a responsible way to meet the presently unmet needs of millions of Americans. In the meantime, there are some options available to people who do their homework because they are finding their medications are too expensive for their budgets. Especially in New York State, people ought not have to choose between medicine and food if they don’t have enough dollars to stretch. New York has a really good program called EPIC (Elderly Pharmaceutical Insurance Coverage) which provides substantial discounts for prescription drugs. The amount of the discount is based on income. You can find a pamphlet describing this program at most pharmacies. Alternatively, the toll free phone number is 1-800-332-3742. If you will use the internet - something you can do with the help of a librarian at your local library if you’re not fluent in computers, you can look up information about EPIC by checking its web site. The address is http://www.health.state.ny,.us/nysdoh/epic/faq.htm. It’s not complicated to apply for EPIC and you have nothing to loose by trying. There are other, less well known ways that drugs can be obtained at little cost. Some drug companies have programs through which medicines they produce can be obtained either free or at very greatly reduced rates although these programs often operate on a limited basis. The Pharmaceutical Research and Manufacturers of America is a good source for finding out what drugs can be obtained and how to access them. Going on the internet is the easiest way to get information. The address, the first letters of the name of the group, is http://www.phrma.org/. Yet another source of very helpful information regarding where to get deeply discounted drugs can be found through a program set up by the National Council on the Aging. They’ve developed a computer program called BenefitsCheckUpRx; it asks seniors for some brief information about their medical needs, finances, etc., and gives them a listing of programs through which they would be eligible for medications at a reduced cost; their files include information about 240 programs providing over 800 prescription drug. The program displays all the programs for which the user is eligible along with instructions on how to enroll. The web address is www.BenefitsCheckUp.org. Librarians can be very helpful at accessing internet sites for people who aren’t comfortable working with computers. So, if what you pay for prescription drugs feels exorbitant, run to one or all of the three options I’ve just described. You may very well find help. In the meantime, don’t forget to write your congressperson, our senators, and President Bush. |