Texas AIDS Coalition Informs Public on Medicare D Prescription Drug Plan

The Texas AIDS (Acquired Immune Deficiency Syndrome) Advocacy Coalition held a forum recently to inform caseworkers and the public about Medicare Part D and the way it will affect those who are currently enrolled in the AIDS Drug Assistance Program (ADAP).

John Coburn, with Health and Disability Advocates, and Dwayne Haught, with the Texas HIV Medication Program, attempted to explain the ways that the programs will continue to provide assistance to those in need. Medicare Part D is a new section providing prescription coverage.

“Medicare Part D may actually make people better off and cover a lot more people,” said Coburn. Starting in January 2006 many Medicare clients will get their drugs through the Part D Prescription Drug Benefit. These plans – or formularies – will be released on Oct. 15th to caseworkers and information will be sent to Medicare recipients on drug plans available in their area.

People who are currently enrolled in the AIDS drug program or both programs must enroll in Medicare Part D to continue receiving Medicare assistance. Although the hope for Medicare is to cut down on the state dollars being spend on AIDS and HIV medications, the cost to clients can total up to $3,600 apiece.

Under the Part D basic coverage, a person will pay the first $250 of the drug costs, or the deductible. This figure may alarm some clients, but the actual “out of pocket” expense, whether $3,600 or lower, does not have to come from the consumer. “Out of pocket” can include amounts paid by the client, friend, or relative, drug company’s assistance program, and the state’s SPAP money.

Currently ADAP receives its funding from the state. Depending on income level and eligibility, some consumers will automatically get extra help through the Medicare or Medicaid savings programs. Current Medicare recipients can sing up between Nov. 15th and May 15th – the last day to enroll. “That would be $.30 a month, so if you waited a year that would be thirty times twelve which doesn’t seem significant to me,” said Haught. “But if you’ve got a 12 percent penalty because you have waited 12 months it is whatever the premium is that year,” said Coburn. “This whole thing is gong to be real tough, but I am optimistic,” said John Tuttle with the Thomas Street Health Center in Texas.