From the Editor, Mary Johnson
Over the years The Social Security & Medicare Advisor newsletter has gained a reputation for explaining Social Security and Medicare in simple terms that anyone can understand. In preparing this issue, however, we are facing our biggest challenge ever — explaining the complicated and confusing new Medicare prescription drug benefit, Medicare Part D.
I knew what we are up against when I received a call from Mary Knowles, an associate editor who helps keep The Advisor simple and clear. Mary K. was sure there was some sort of mistake. What threw her (and all of us) is the so-called "doughnut hole" or gap in coverage. The new benefit provides coverage to a certain amount of drug costs (see details below) then suddenly stops. At that point you pay 100% of your drug costs from $2251 to $5,100 out-of-pocket.
"The $2251-$5100 gap seems weird; how are seniors going to cover that???" Mary asked. That's one question even The Advisor can't answer right now. Under the new Medicare drug law, Medigap plans will NOT be allowed to cover the gap in drug coverage. Seniors will be on their own.
If the following article sounds confusing (it will), and if it sounds like surely there must be some sort of mistake (we've double and triple checked the facts), please understand that we've done our best. This is, however, how Congress designed the program. But we can help change that.
TSCL believes that, for a Medicare program to be as fully utilized by seniors and the disabled as it should be, it must be kept very simple to understand and use — far, simpler than the current program. A benefit that is too complicated to be used is as bad or worse than no benefit at all. TSCL is working with Members of Congress to enact a simple, traditional Medicare drug benefit for seniors.
None of us needs more hoops to jump through. A reasonable drug benefit should offer uniform coverage and premiums to every beneficiary. It should also give us access to the lowest prices that Medicare can negotiate for us.
It remains to be seen whether new the drug plans will work. In the meantime, here at The Advisor we are working to Keep it Simple!
June 2005
