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Seniors get help with prescription program

December 07, 2010|By HEATHER KEELS | heather.keels@herald-mail.com

HAGERSTOWN — A free workshop held at the Ramada Plaza Hotel on Wednesday featured a breakfast buffet, but for many of the seniors who stopped by the “doughnut holes” of greatest concern were not to be found on their plates.

The workshop, offered by the Maryland Senior Prescription Drug Assistance Program, helped eligible seniors sign up for state subsidies to help lower their prescription drug costs.

In addition to offering subsidies of up to $35 a month toward Medicare premiums, Maryland also offers subsidies that help cover prescription drug costs in the “doughnut hole,” a coverage gap in Medicare Part D in which users must pay for prescription drugs out-of-pocket, said Johnette Watson-Tabron, an educational counselor for SPDAP.

That subsidy is increasing in 2011 to cover 95 percent of total drug costs, Watson-Tabron said.

Watson-Tabron said one local woman she helped was paying more than $400 a month for prescription drugs. With the state subsidy, that cost will drop to $16 a month, she said.

To qualify for the state subsidies, applicants must have lived in Maryland for six months, be enrolled in a Medicare Part D or Medicare Advantage prescription drug plan and have an income of less than $32,490 for an individual or $43,710 for a couple.

Watson-Tabron said the doughnut hole is posing a worsening hardship for seniors on Medicare. Five years ago, many of the people she worked with weren’t reaching the cost threshold where they had to begin paying out-of-pocket until the final two months of each year, she said.

“Now, some of them are going into the hole in February,” she said.

The change is the result of several factors, including rising drug costs and reclassifications of drugs within the Medicare system, Watson-Tabron said.

“It’s getting crazy, when you’re looking at people whose total income might be $1,000 a month, and they’re paying $600 a month on drugs,” she said.

Bill Hasenbuhler, 74, of Fairplay, said he was a good example of the hardship of high prescription costs. Opening a notebook he keeps of charts and graphs documenting medical expenses for himself and his wife, Sylvia, Hasenbuhler pointed to a graph of income and out-of-pocket prescription drug costs. For 2009, it showed income of about $24,000 and prescription drug costs of nearly $15,000.

The prescriptions Hasenbuhler takes are mostly “maintenance” drugs, he said — cholesterol medications, insulin — but without aid, his Social Security income would never cover them.

“If it wouldn’t be for this program, I would probably have died; it’s as simple as that,” he said.

About 80 seniors participated in Wednesday’s workshop, but SPDAP officials suspect thousands more are missing out on available assistance.

Those who missed the workshop can call the program at 1-800-215-8038 between 9 a.m. and 5 p.m., Monday through Friday, for enrollment help. For coverage beginning Jan. 1, the open enrollment period ends Dec. 31.

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