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What’s Happening to Medicare Part D? Part II

Last week, we reported on proposed changes to Medicare Part D that could have made it harder for millions of seniors to obtain prescribed medicine. One congressman from Pennslvania, Tim Murphy, went so far to say that suicide rates would increase as a result of the proposed changes, referring to a change that would have allowed insurers to reduce coverage for antipsychotics, immunosuppressants, and antidepressants. Other proposed changes included allowing the government to intervene in contracts between insurers and pharmacies, limiting the number of drug plans available, and also expanding access to community pharmacies.

Outcry from both sides of the aisle, as well as patient and consumer rights advocates, has resulted in the Obama administration reversing course on the changes. “We will engage in further stakeholder input before advancing some or all of the changes in these areas in future years,” wrote Marilyn Tavenner, Administrator of the Centers for Medicare and Medicaid Services.

We are glad specifically that coverage for critical medication will remain strong and that the number of drug plans will not be limited in certain areas. We know that the intention of reducing drug plans was to help make it easier to choose a plan. On the other hand, we support expanding access to community pharmacies and hope for further action on that front.

Fortunately, there are online resources that can help with this. Not all Medicare drug plans are created equal. PharmacyChecker.com runs MedicareDrugPlans.com, which you can use to compare plans and read or write reviews on those plans available in your area.

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What’s Happening to Medicare Part D?

Future Changes to Medicare Part D may curtail access to affordable medication for millions of seniors enrolled in Part D prescription drug plans, according to Kaiser Health News and USA Today.

The Obama administration wants to remove three drug classes, immunosuppressants, antipsychotics, and antidepressants, from the list of specially protected drugs. What this means is that insurers would no longer be required to cover the majority of these drugs in those classes. What that means is that more  patients will struggle to afford – and even skip – medications due to high out-of-pocket costs at U.S. pharmacies.

An alliance of Democrats, Republicans, drug companies, and patient advocates oppose the proposal. Rep. Tim Murphy, R-PA, who is also a psychologist, fears the worst: “If you restrict access to these drugs you restrict the treatment of mental illness,” he said. “You raise suicide rates.” Murphy’s sharp statement suggests just how important drug coverage for Medicare beneficiaries is. Over half of seniors aged 65 or older take at least five prescription drugs, and a carefully organized prescription plan may have disastrous side-effects if a drug is switched for another. Such substitution would likely occur for many patients if drugs are removed from special protection. (more…)

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