Medicare donut hole

This week The Stu Pitt Award goes to ...

The U.S. Congress 2006-2012

for their disasterous donut hole

For those of you who are not familiar with the dreaded donut hole it’s the gap in Medicare coverage where Medicare drug plans currently cover only 50% of the RETAIL price of brand name meds and 70% of generic brands. This could and does cost millions of seniors hundreds of dollars each month … out of pocket.

As many seniors are on fixed incomes the donut hole can force the choice of “do I buy food or pay for my medications?” Surveys show that many seniors can not afford to do both and, as a result, stop taking heart meds and other life saving prescription drugs. Why not just switch to generic medications? Because, despite what we’ve been led to believe, sometimes generics just don’t work, or sometimes don’t work as well as the brand name.

In July, 2012 I suddenly fell into the dreaded donut hole. How? In June I inexplicably started to have severe constant atrial fibrillation. My cardiologist put me on 5 new medications. I tried the generic brands but some of them simply did not work for me. When I went to refill the prescriptions the next month I suddenly found myself falling deep into the dreaded donut hole, with the cost of my daily medication co-pays skyrocketing to over $500 a month! Out of pocket. I had fallen into the donut hole and couldn't get out. I was now paying 50% of the retail price for my life saving brand name meds. One brand name co-pay was $157, another was $121. Co-pay. For a 1 month supply. Plus, I now had to pay 50% -70% of the retail price of my other 5 medications. Each month. Total? Over $500 a month. Out of pocket.

I fell into the Medicare donut hole. More like the rabbit hole, from Alice in Wonderland. Pure insanity. As a senior citizen, born and raised in America, I worked, I paid into Medicare, I got Medicare, only to find myself in the Medicare nightmare called the donut hole. The donut hole is costing me $500 a month. And I probably have to live in this donut hole nightmare until a new year starts, 5 1/2 months away. Yes, I am aware that there are government and private programs which can financially help low/no income seniors who are in the donut hole. In my case, I do not qualify.

Being forced, as a senior on social security and Medicare, to spend $500 a month out of pocket for life saving medications, is crazy. It’s stupefying. It’s frightening. It’s maddening. It’s the government.

Under George Bush, Congress instituted the donut hole in 2006. Under ObamaCare, the Medicare donut hole was reduced by 50%, an improvement, but, at an out of pocket cost of $500 a month, is still totally unacceptable. Seniors on Medicare will have to wait until 2020 for the dreaded donut hole to close, when many of those who need meds the most and can afford them the least, may already be dead. What about Congress, they voted to put the donut hole in Medicare, can’t they fix it? Yes, but they didn’t and won’t, until 2020. Instead, since 2006, Congress has chosen to throw millions of seniors under the bus, or in this case, into the donut hole.

My Medicare is now costing me over $800 a month total! $300+ a month in premiums and $500 in prescription drug costs. $800 a month. That is NOT what seniors over the age of 65 in America should have to pay each month for medical care and medications!

I, and millions of other seniors, fall into the donut hole and can't get out!

The Medicare donut hole is tantamount to severe financial abuse of seniors. Financial abuse of old, poor and sick citizens of the United States of America. For shame! Shame on Congress. Shame on the President of the United States. Shame on the medical profession. Shame on the Medicare insurance industry. Shame on every lawmaker/politician in Washington who was there when the Medicare donut hole was allowed to happen in 2006 and shame on every one of them in Washington now who continues to allow it to happen.

Shame, shame, shame!

Congratulations, Congress, for your disasterous anti-senior Medicare donut hole, you deservedly earned the Stu Pitt Award!