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Prescription Drug Coverage for Seniors

Location: Unknown

December 30, 2005

Medicare was created over 40 years ago to meet the health care needs of seniors and individuals with disabilities. In 2003, to strengthen this important program, Congress passed, and President Bush signed into law, the first major reform in Medicare history. This legislation creates a voluntary prescription drug benefit for all 40 million seniors and disabled Americans in the Medicare program.

Medicare has simply not kept pace with the groundbreaking advances in modern medicine. In the last decade alone almost 400 new drugs have been developed to fight diseases which touch every American's life. Yet prior to passage of this legislation, Medicare, amazingly, would reimburse for expensive surgeries and medical procedures, but not for prescriptions that would prevent those procedures. This is staggering considering that 80% of retirees use a prescription drug every day, and nearly 40% of a senior's health care bill is spent on pharmaceutical medicines.

On November 15, 2005, Medicare beneficiaries began signing up for this new prescription drug program. Beneficiaries have until May 15, 2006 to sign up for this new coverage without incurring a penalty. Seniors can choose from at least 10 national plans and additional regional or state plans, depending on where they live, that cover brand name and generic drugs. According to the Centers for Medicare and Medicaid Services (CMS), a typical beneficiary with no coverage today will save about 50% on prescription drug costs. The average plan will include a $32 average monthly premium and a $250 annual deductible. The prescription drug benefit will cover 75% of drug costs from $250 to $2,250 annually and 95% of drug costs will be covered over $3,600 annually.

Additionally, about one-third of seniors will be eligible for a Medicare drug benefit with little or no premiums, low deductibles, and no gaps in coverage. Those with the lowest incomes will be assigned plans and will pay no premiums or deductibles. People with limited income may qualify if in 2006 they are single and have resources less than $11,500 or married and have resources less than $23,000.

I encourage Medicare beneficiaries who want to sign up for the new prescription drug coverage to contact CMS at 1-800-MEDICARE. If you need more information on this new benefit you may contact one of my offices or visit the CMS website at

This new prescription drug program offered by Medicare will help America's seniors meet the cost of vital medication. Everyone with Medicare is eligible for the coverage, regardless of income level and resources, pre-existing conditions, or current expenses. This benefit will help America's seniors stay healthy longer, and reduce the burden of financing the often-costly expense of prescription drugs.

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