Even those who don’t hit the coverage threshold struggle financially. Forty-four percent of Medicare recipients in the survey noted that medical expenses have put a great strain on their finances. Almost 60 percent of respondents on Medicare spend between $2,000 and $10,000 per year on premiums, deductibles and out-of-pocket medical expenses. More than 10 percent spend more than $10,000.
Your Voice is heard
“I hit the doughnut hole every year and have to go a month or two without some of my meds, because I just cannot afford them.”
– respondent with OA
“When you get in the doughnut hole, you’re on your own. You might as well not have any insurance at all.”
– respondent with RA
“After Medicare and prescription premiums and co-pays, I have less than $800 for the month. Then I pay mortgage and utilities, and sometimes I cannot [afford to] eat much at all.”
– respondent with RA
“There are too many variables in choosing a Medicare [prescription] plan. There is no way to get the ‘best deal.’”
– respondent with OA; spouse with RA
“I made it all the way through the doughnut hole by the middle of May this year. The two months of full-price payments during that time made me cry.”
– respondent with RA
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But people are worried about more than bureaucracy and cost. Other problems cited in our survey include confusion over plans, getting questions answered, too few specialists and the doughnut hole, which requires recipients to pay 100 percent of their expenses after they have reached a certain dollar amount. Since the Medicare Part D prescription drug plan took effect in 2006, this doughnut hole amount has risen each year; in 2008, the doughnut hole begins when the recipient’s total drug expenses hit $2,510 – which includes the recipient’s out-of-pocket expenses and the plan’s expenses. The gap in coverage continues until the Medicare beneficiary spends about $3,200 more, after which catastrophic coverage kicks in.
