Mind the Gap

This one is off topic…but I have to rant. I was able to spend a full week at home with my mom for Christmas. I had a great time in balmy Northwest Ohio. See for yourself.

This rant is directed at the "brain trust" that dreamed up Medicare Part D. For those of you who don't have a retired parent, Medicare Part D is the prescription drug coverage plan that began enrollment this year. My mom enrolled in May. She had to decide by December 31 if she wanted to keep her existing plan or switch to a new one. Medicare allowed participants to switch plans in 2006…that's not the case in 2007. So, we needed to make sure mom was happy with her plan.

I pulled a lot of data from the Medicare web site prior to Thanksgiving. My sister and I went over the information with mom. We decided it was best to stick with her current plan. My cousin recommended two additional plans at the beginning of December. I pulled the new information and took it home for Christmas. During our latest conversation last week another plan cropped up. [There are 60 plans available in Ohio.] Mom doesn't have broadband and dial-up is a pain at home, so I waited until I got back on Tuesday to do more research.

I pulled up the data and about fell off my chair to see that the annual costs [monthly premium + staged drug costs] had doubled on mom's plan.  This doubling happened over Christmas. Upon further data manipulation I realized that the culprit was a brand name drug with no generic. I then realized that the real culprit was her preferred chain pharmacy [three letter name beginning with C and ending in S and there might be a V in the middle] had increased the price they were charging for the brand name drug. This price increase would put her into the gap [a.k.a. dounut hole ] in August. If she goes with an independent pharmacy or uses mail order the price drops back down to the original number and she goes into the gap later or not at all.

I find the information research process frustrating [that's saying a lot for a librarian]. The plan comparison tool on the Medicare web site is better than what you would expect from the Federal government. However, it has some nuances that I suspect many senior American's would miss. For example, the site uses CSS to display the plan data and show how much the drugs would cost monthly and when you would go into the gap. The detailed listing of this data is collapsed on the first screen. You have to know to click on the + to expand the section. 

You would think there would be a better way to do this. Consumer choice and competition only go so far…and then you get a headache and want to pull your hair out. I can only imagine what others [public librarians included] have been going through with their parents [patrons], or worse yet, trying to figure it out on their own. Whatever you do, make sure to mind the gap!

One thought on “Mind the Gap”

  1. The “donut hole” you speak of is exactly why I have my job with the Township. The former Fiscal Officer was retired from a company, working for the Township, and made the switch to Medicare D. Because of his prescription needs, he quickly fell into the “gap” and upon getting the first bill after falling, which totaled more than $1000.00. he quickly realized his only option would be to retire from the Township so he could afford his prescriptions. Sad situation.

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