From the Sarasota Herald-Tribune:
In health care circles, Monday is Doughnut Hole Day, the deceptively storybook name for a nasty plot turn in the drama of getting prescriptions filled when you’re over 65 and living close to the bone. The hole is the gap in coverage built into Medicare’s Part D prescription drug program, which pays most of the first $2,250 in patient prescriptions and 95 percent of drug expenses over $5,850.
Doughnut Hole Day is the point on the calendar at which large numbers of people with chronic illness begin to exceed $2,250 in drug costs, leaving them to pay full price for their prescriptions until they have spent $3,600 out of pocket.
An August Kaiser study showed that one in four seniors fall into the doughnut hole each year, and that many stop taking needed medications as a result.
What, if anything, do the presidential candidates plan to do about the Medicare doughnut hole?
Here’s one analyst’s take on John McCain’s position:
McCain was absent on the vote to repeal the Bush administration ban on government use of its bulk purchasing power to negotiate lower prices from drug companies for Medicare recipients. He’s been silent on the doughnut hole, under which seniors must pay 100 percent of the next $3,000 in drug costs after Medicare pays 75 percent of cost for the first $2,700, and mum on insurance industry price gouging in the Medicare Advantage program in which payments to private plans average 113% of the cost of care for comparable seniors in regular Medicare.
Obama, meanwhile, has stated that he would close the doughnut hole if elected.
Of course, with the economy a mess and the federal government spending upwards of a trillion dollars to bail out the financial services industry, an Obama administration would have a hard time mustering support for new government spending to help out seniors.
So Doughnut Hole Day is probably here to stay for a while — and, in fact, is predicted to begin coming earlier in the year, as the Medicare coverage gap is expected to increase without federal intervention.
The Dallas Morning News has a worthwhile story on “doughnut hole season” here.104