About 9,000 Medicare beneficiaries in Montana will receive prescription drug relief under Affordable Care Act

Billings Gazette

by Cindy Uken

At the end of last year, at least 7,756 Medicare beneficiaries in Montana have received prescription drug cost relief through the Affordable Care Act.

And another 1,000 are expected to receive a rebate in the first quarter of this year.

To date, 3 million Americans who fell into the drug coverage gap known as the doughnut hole” during 2010, have been mailed a one-time, tax-free, $250 rebate check. Nearly 9,000 of those are Montanans, said Kimme Evermann of the State Health Insurance Program.

Montana has thousands of senior citizens and residents with disabilities who struggle with the cost of prescription drugs, forcing some to choose between filling their prescription or buying food, according to health officials.

“These kinds of choices bother me to the core,” said U.S. Sen. Max Baucus. “When I hear the stories of what people go through because they're in this predicament called the so-called doughnut hole, it's especially troubling because the gap in coverage is so arbitrary.”

While Baucus said he's glad thousands of Montanans are receiving the $250 rebate check, it's not enough for those who easily spend that much every month on prescriptions.

The $250 rebate check is only the first step in how the Affordable Care Act will reduce prescription drug costs for people in the hole each year until it is closed in 2020.
Beginning this year, eligible beneficiaries in the coverage gap will receive a 50 percent discount on covered brand-name medications.

In addition, in 2011 Medicare will begin paying 7 percent of the price for generic drugs during the coverage gap.

According to the 2010 Census, there are 167,585 Medicare beneficiaries in Montana, about 17 percent of the state's population. In addition to savings on prescription drugs, the law provides new benefits to Medicare beneficiaries when they visit their doctor starting this year, including:

As of Jan. 1, 2011, Original Medicare no longer charges out-of-pocket costs for the “Welcome to Medicare” physical exam and, for the first time since the Medicare program was created in 1965, Original Medicare now covers an annual wellness visit with a participating doctor.

Most people with Medicare can also now receive free critical preventive services, including certain cancer screenings such as mammograms and colonoscopies.

Also this year, the Affordable Care Act will provide qualifying doctors and other health care professionals in Montana a 10 percent bonus for primary care services. This will help ensure that those primary care providers can continue to serve Medicare patients.