Tiered Part D System Burdens RA Patients/Medicare | Arthritis Information

 

LITTLE FALLS, N.J., June 4 -- The sickest and poorest Medicare patients enrolled themselves in Part D prescription plans that were less generous and had more restrictions than Medicare Advantage plans, researchers say.

As a result, patients with rheumatoid arthritis shouldered a heavier financial burden for expensive biologic, disease-modifying antirheumatic drugs (DMARDs) than those in other plans, Jennifer M. Polinski, M.P.H., of Brigham and Women's Hospital in Boston, and colleagues reported in the June 15 issue of Arthritis Care & Research.

"Such cost shifting may place these medications out of the beneficiary's financial reach and expose Medicare to high financial liability," the researchers said.

I have Medicare Part D. It now has a Tier 4 for the new drugs. The co-pay is 35% of the drug cost. Something that I and the majority of RA patents cannot afford. 35% copay?  on a biologic?  who can afford that?  what are they, nuts? This does not surprise me at all. If it sounds too good to be true, then avoid it.   This is not new for me.  When I first went on Medicare,  after being disabled for 2 years, I joined a Medicare Advantage Blue Cross group and the tier 4 was in effect back then at 30%.  It is now 35%.  Even tier 3 drugs are beyond my ability to pay each month when you add in the other tier 2 and 1 drugs I take.  Now that I am officially a senior, the same policy applies.  The mother of a friend is on a biologic and it's fully covered by Medicaid because she is very low income.  Is this fair???  We absolutely need changes in the health care system in this country. 
Copyright ArthritisInsight.com