Although 2003 legislation created Medicare Part D to pay for prescription drugs, there is a gap in coverage known as the doughnut hole that occurs when the federal government stops paying for drug purchases as an annual limit is reached. Once a patient hits that limit, the government picks up the tab again only after the patient has spent thousands of dollars.
Dick Robbins, 72, who lives in Hot Springs Village, Ark., discovered this after he reached his reimbursement limit in 2007.
"It's a financial burdenpart D Medicare doesn't cover a heck of a lot of the stuff I use, they only cover part of it," said Robbins while he was in the doughnut hole. "Now I pay full price for everything I take." Robbins is taking metformin and two types of insulin, Novolog and Lantus. The medication and syringes are costing him up to $300 a month with Medicare's help and up to $800 a month when he has to pay it all himself.
"My feeling is, one of the villages in America is missing its idiot, and he's working for this health-care company."
Resources to manage costs
If you are on Medicare and have limited income and resources, you may qualify for extra help paying for your prescription drugs. For more information, go to the "Getting the Help You Need" section of the online publication Medicare & You 2008.
If you don't have prescription drug coverage, you may qualify for free or low-cost prescriptions. The Partnership for Prescription Assistance, a pharmaceutical industry-sponsored initiative, can tell you more.
The American Diabetes Association has more about coverage of diabetes costs by Medicare, Medicaid, and private health insurers.