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All Vermont Seniors
Would Have Prescription Drug Benefit
Under Leahy-Backed Bill
BURLINGTON – The U.S. Senate has begun a major
debate on proposals to reduce prescription drug costs, centered on a
bill to add a prescription drug benefit to Medicare that is
cosponsored by Senator Patrick Leahy, who released Vermont coverage
figures on Monday in Burlington. The Graham-Miller-Kennedy bill
would offer comprehensive, affordable and reliable prescription drug
coverage for every senior citizen and disabled Medicare beneficiary in
Vermont.
The benefit would cover every prescription
without any deductible or coverage gaps for a fixed monthly payment of
$25. Every senior living below 150 percent of poverty would qualify
for extra assistance under the Medicare Outpatient Prescription Drug
Act.
Unlike the plan backed by Leahy, the competing
prescription drug bill has private insurance companies receiving
subsidy payments from the government to provide benefits to seniors.
Monthly payments that seniors would pay would be determined by the
company, and no coverage would be available if insurance companies
decline to participate.
Though 87,000 Vermonters are enrolled in
Medicare, said Leahy, fewer than one percent are enrolled in Medicare
HMOs. The median income of Vermont’s senior citizens is $10,946,
while 28,000 seniors have incomes 150 percent below the poverty
level. 21,000 Vermont seniors have prescription drug coverage under
employer retirement plans, which the bill would maintain.
The Medicare Outpatient Prescription Drug Act (S.
2625) supported by Leahy includes:
- premiums of $25 a month/$300 a year with no
deductible,
- copayments of $10 for generic drugs, $40 for
medically necessary preferred brand name drugs until they have
reached $4,000 of out-of-pocket spending, at which point Medicare
pays all expenses,
- assistance beginnng with the first
prescription -- there are no gaps or limits on the coverage, and
- special assistance for individuals with
incomes below 150 percent of poverty.
The bill is now being debated by the Senate,
along with competing plans, and Democratic senators have made enacting
a prescription drug benefit under Medicare this year a top priority.
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