Complain about a product or service

AARP Wants Changes in Medicare Rx Plan

Wants Government to Help Control Drug Prices

January 28, 2006

Medicare Drug Plan • House Passes Bill to Cut Medicare Prescription Drug Costs • Study Finds "Tremendous" Disparity In Medicare Prescription Drug Prices • Medicare Drug Plan Costs Rising • Medicare Call Centers Inadequate, Report Charges • Report: Shopping Around Beats Medicare Drug Prices • Confusion Ahead: New Medicare Plans for 2007 • GAO Faults Medicare Help Lines • Medicare Scams Feared As Deadline Approaches • Medicare Drug Plan: Big Win or Big Flop? • AARP Survey Finds Medicare Rx Is What the Doctor Ordered • NY Consumer Group Challenges Medicare Enrollment Numbers • States' Suit Challenges Medicare Drug Plan • AARP Wants Changes in Medicare Rx Plan • States Sue Peoples Benefit Services • Rampant Fraud Feared as Medicare Drug Benefit Ramps Up • Biggest Medicare Drug Benefit Challenge: Understanding It • Deciphering the New Medicare Drug Program • Beware! Scams Abound • How to Spot a Scam • Seniors Try to Decipher New Drug Program --- • More Medicare News ...

AARP says it will ask Congress to change the new Medicare prescription drug program, giving more help to elderly people with low incomes and creating a bigger government role in policing drug prices.

AARP initially supported the program but said just before its passage that it might want to "build on it in the future." In a statement, AARP President Bill Novelli said problems with implementation of the drug assistance program needed to be addressed.

Additionally, John Rother, AARP's chief lobbyist, said his organizations wants Congress to change the way Medicare recipients' assets are counted in determining which ones are poor enough to qualify for special low-income subsidies, The Washington Post reported.

Also, Rother said AARP wants to reopen debate over a provision that would have directed health officials to negotiate directly with drug manufacturers over the prices they charge through the program. The White House has said that President Bush would oppose any attempt to revise the program.

AARP and Congressional Democrats had pressed for government price controls when the legislation was being debated. The Bush Administration favored a market-oriented approach that was eventually adopted, in which drugmakers negotiate prices with the insurance plans that sell the drug benefit to patients.

In his statement, AARP's Novelli said there had clearly been problems with implementation of the program.

"The bottom line is that some people are not getting the drugs they need. This is unacceptable," he said. "If an individual has proof of eligibility, there is absolutely no reason they should pay more than required or leave a pharmacy empty-handed."

AARP has been under attack from conservatives, who accuse it of pushing liberal programs, and from many of its own members, who accuse it of caving in to Republican pressure to support the GOP-backed Medicare plan.

Democrats in Congress have been promoting a bill that would make fundamental changes in the drug benefit. One of those changes would be empowering the government to jawbone drug makers, one of the revisions AARP now says it supports.

Cheaper than Canada

Novelli and other AARP executives insist the Medicare drug assistance program is not all bad.

An AARP investigation last month found that for many Americans, Medicare drug plans that cover all of a beneficiary's drugs can cost less than buying the same drugs across the border. The calculation takes into account premiums, deductibles, and copayments.

Pill for pill the actual price of some drugs may be cheaper in Canada but Medicare coverage is insurance, and so enrollees are therefore charged only copayments instead of full price.

The findings, detailed in the AARP Bulletin, emerged from an analysis of real combinations of drugs taken by people across the country. Using the drug plan finder on Medicare's website, AARP found the least expensive Medicare "stand alone" plan that covered their drugs and compared that plan's total cost to what that person spent in a year buying the drugs from an online Canadian pharmacy.

AARP used the plans' 90-day mail-order options because that's how more than 1 million consumers over 65 routinely get their drugs from Canada.

An example can be found with an interviewee named Donna from Anaheim, California.

Donna would pay $2,323.68 overall under a Medicare plan in her area for coverage of her six drugs – nearly $1,400 less than the $3,718.40 charged by a low-cost Canadian pharmacy. This Medicare plan charges relatively high monthly premiums of $50.91 but has no deductible and gives continuous coverage for all her drugs through the "doughnut hole" gap. Her copays would range from $17.50 to $150 for every 90-day supply.

AARP's free publication, "The New Medicare Prescription Drug Coverage: What You Need to Know," is available in Spanish and English to members and non-members alike. This easy-to-understand resource describes how the new plans work and how to find enrollment assistance. To order the publication or get help, people can call AARP toll-free operators at 1-888-687-2277 or go to AARP's educational guide.

Enrollment information is available through state health insurance counseling programs (SHIP) in all 50 states and at many senior centers and offices on aging. Beneficiaries can find their local SHIP office online or by calling 1-800-677-1116.

Medicare's drug plan finder and other details are also available online. Or beneficiaries can call Medicare toll free at 1-800-633-4227 for assistance.

Report Your Experience
If you've had a bad experience -- or a good one -- with a consumer product or service, we'd like to hear about it. All complaints are reviewed by class action attorneys and are considered for publication on our site. Knowledge is power! Help spread the word. File your consumer report now.