Pawtucket, RI – Since the Medicare Part D prescription drug plan went into effect in January 2006, seniors and people with disabilities in Rhode Island have too often been victimized by the “doughnut hole,” a gap in Part D coverage which exposes patients to the full cost of prescription drugs. Today, U.S. Senator Sheldon Whitehouse brought good news to seniors at Pawtucket’s Leon Mathieu Senior Center: the health care reform legislation passed this year will completely close the doughnut hole by 2020, and, as a first step, provides payments of $250 to anyone affected by the doughnut hole this year.
“Since I ran for the Senate in 2006, I’ve heard countless horror stories about folks affected by the dreaded Medicare Part D doughnut hole,” Whitehouse said. “Far too many seniors are forced to choose between taking their medication and putting food on the table or paying their bills. This is unacceptable, and these payments mark the first step toward fixing the problem. For Rhode Island seniors who have been hit hard by the long recession, this will be welcome relief.”
Medicare Part D recipients lose their prescription coverage after yearly drug expenses exceed $2,830. Drug coverage doesn’t resume until they spend $6,440 for the year – a high threshold for seniors on low fixed incomes. This sudden and often unexpected rise in prescription costs can be devastating. Roughly 15,100 Rhode Islanders are affected by the doughnut hole each year.
The $250 payments began last Thursday and will continue for the rest of this year. Starting in 2011, seniors will receive a 50% discount on brand name drugs purchased while in the doughnut hole. In 2013, the federal government will also pick up a share of brand name drug costs, starting at 7% the first year and increasing to 25% by 2020. Combined with the 50% discount and the standard 25% patient copay, that means seniors will receive full Part D coverage for brand name drugs by 2020. For generic drugs, the doughnut hole will begin to close in 2011, with the federal government picking up 7% of costs, increasing to 75% by 2020.
Whitehouse was introduced at the event by Travis Savoie, who in 2006 first told the Senator about his great-grandmother’s struggles with the doughnut hole. Since then, Whitehouse has been committed to closing the doughnut hole, and has sponsored legislation in the Senate aimed at achieving that goal. During the past year’s debate on health care reform, he urged Senate leaders to include a doughnut hole fix in the reform legislation.
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