Closing coverage gap a good thing
The choice of buying food, paying a bill and purchasing medication is one many people across Shelby County face each month. Nearly 50 percent of all callers to the Middle Alabama Area Agency on Aging (M4A) are seeking assistance for life-sustaining medications. In addition, many older Alabamians are returning to work in order to make ends meet, to pay bills and purchase necessities like medications.
In 2002, the state of Alabama Legislature designated funds to assist older individuals with medication needs; this program is called SenioRx.
The program was originally designed to help individuals 60 years of age and older access free or significantly reduce-priced medications through pharmaceutical companies but was later expanded to include individuals who are Social Security disabled and those in the Medicare Coverage Gap.
Statewide, since its inception, SenioRx has saved Alabamians $208 million in prescription medication costs. In Shelby County alone, over 730 individuals have been helped, saving them more than $3.4 million in medication costs since May 2002.
Resources are available online to access medication assistance; however, many individuals do not have Internet connection, a computer, printer or the computer skills necessary to find the appropriate forms. The forms themselves can be overwhelming and daunting to complete, with some forms only being available to medical doctors.
Additionally, documentation of income, copies of prescriptions and signatures from physicians are also required. These factors make it essential to have trained professionals in community-based agency who can assist individuals through this process free of charge.
Recent changes to Medicare by the Federal Government propose to eliminate the Medicare Coverage Gap in the coming year. As an initial step, the government provided a stipend of $250 per person who fell into the coverage gap this year. These initiatives are extremely helpful, since those who fall in the gap are required to pay 100 percent out-of-pocket for medications while they are in the gap.
Closing the Medicare Coverage Gap will also greatly benefit Medicare beneficiaries. Nonetheless, older individuals and those with disabilities will continue to have copayments, deductibles and medications that are not included in a formulary. Thankfully, they will also continue to have the SenioRx Program to assist them with the cost of their life-sustaining medications.
Kelly Lippert-Flick is the community relations coordinator for the Middle Alabama Area Agency on Aging, which is a member of Shelby County Voluntary Organizations Active in Disaster.