Sunday, May 21, 2006

Medicare Part (D)isaster Doughnut Hole Is Here

Harry DiOrio, KRT
Heart transplant recipient Frank Furfaro, of Patchogue, New York, can no longer afford his life preserving medication since his plan adopted the new Medicare drug benefit.

Every Senator and Congressman who voted for this (D)isaster should have it hung around his neck for the November elections.

Knight-Ridder: Millions face a `doughnut hole' lapse in Medicare coverage

Last year, Frank Furfaro of Patchogue, N.Y. had drug coverage through his Medicare managed-care plan that he felt was adequate. But when his plan adopted the new Medicare-drug benefit, things changed. First, his premiums increased. Then he noticed that the plan covered fewer of the drugs he took.

Furfaro, a disabled heart-transplant patient, found out that he'd hit the doughnut hole last month when he tried to fill a prescription for two immunosuppressant medications. Instead of two $25 co-pays, the pharmacist charged him $661 and $329 for the prescriptions.

"I threw a fit," he said. "What am I supposed to do? I don't have $661 in my pocket." Furfaro said he wasn't told about the doughnut hole when his Medicare HMO changed its coverage in January.

Furfaro, 47, left the pharmacy empty-handed, thinking that without his drugs he was going to die.

"I thought, `That's it. It's over.' The three years I put into the transplant, the waiting and everything. It was a waste of time because I can't get my medicine."

His father helped him purchase the cheaper drug of the two. But Furfaro has gone more than three weeks without the other drug, the one that helped him overcome severe organ rejection after the transplant in 2001. Disabled since 2001 and living off a monthly Social Security Disability Insurance payment of $1,171, he recently took a job as a security guard to earn money for his medications.

He's already feeling weaker and tired. "I lay around a lot. I don't have a lot of energy. I'm short of breath. I don't feel well at all," he said.

If his health deteriorates further, Furfaro said, he'll just get admitted to a hospital and receive his medicine that way, as Medicare will pay all bills if he's hospitalized.

That scenario will be duplicated at hospitals nationwide once more people hit the doughnut hole, said Bob Hayes, the executive director of the Medicare Rights Center, a New York-based advocacy group.


As it stands, the doughnut hole stands is an insurance industry anomaly.

"It's not something we've ever seen in any other insurance product that I'm aware of," said Juliette Cubanski, principal policy analyst at the Kaiser Family Foundation.

Previous posts:

'Part D is a complex system of subsidies to private insurance companies' (May 15, 2006)

Medicare Part (D)isaster Penalties: Will Rethugs Blink? (May 13, 2006)

Bush To Old People: Drop Dead (May 10, 2006)

Medicare Part (D)isaster, Incompetently Administered, Misleading Poor Seniors (May 7, 2006)

Most Severely Ill Senior Citizens Already in Medicare Part (D)isaster Doughnut Hole (April 27, 2006)

Medicare Part (D)isaster: Watch Out For That Hole (April 12, 2006)

President Out-of-Touch Moron Meets the Seniors
(March 19, 2006)

Medicare Part (D)isaster: Making the Mentally Ill Sicker (February 6, 2006)

Medicare Part (D)isaster Creating Havoc at Social Security Administration (February 4, 2006)

Right Wing Blogs Exhibit Myopia Over Medicare Part D(isaster)
(January 24, 2006)

Medicare Part (D)isaster (January 20, 2006)

Operation Photo Op, Medicare Part D edition, 1.0 (January 18, 2006)

'Horrific at Best'
(January 9, 2006)

The Incompetence, The Corruption, and The Cronyism: Sunday, January 8, 2006
(January 8, 2006)

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