The plan's objectives were to cover all Medicare recipients at some level and protect the elderly and disabled from massive medical bills. To reach these goals, the plan was designed to stop coverage when drug costs for the year reach a little over $2,000. Once costs go over $5,000, prescription drugs are covered again. This $3,000 gap is referred to as the doughnut hole.
Advocates and health analysts anticipate serious health risks for those with limited incomes who can no longer afford medications while they are in the gap. Although participants are generally at the poverty level, only the poorest can get waivers for their meds, forcing some seniors to choose between live-saving medicine and their next meal. Official estimates have reported that 7 million Americans will find themselves in the doughnut hole this year alone.
Many seniors didn't know about the doughnut hole until they hit the cut-off point recently. Many more seniors are expected to hit the gap in September. Critics say the doughnut hole got little press, because most seniors were bombarded with advertising and focused on deductibles and premiums when they signed up.
Solutions to the doughnut hole include possible price negotiations by Medicare directly with drug companies, or waivers for seniors who have fallen into the gap.
Mike Adams, a consumer health advocate and vocal critic of the Medicare plan, is not at all surprised to see seniors in an uproar. "Underneath all the hype and political posturing, this Medicare drug plan was never designed to save Americans money in the first place," he says. "It was engineered as nothing more than a taxpayer-funded handout to Big Pharma, dressed up to look like a free lunch for senior citizens."
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