Some seniors have coverage gap in plan

Prescription drug bills are shooting up for some Spartanburg seniors who have hit Medicare's prescription drug ceiling. They could spend thousands before the government will subsidize their costs again.

Many local seniors and disabled are pleased with the new prescription drug benefit through the standard Medicare plan. Since sign-up, which many admit was troublesome, they say the new benefit has brought down -- sometimes dramatically -- their monthly medication costs.

But an estimated 3 million to 7 million beneficiaries are expected to hit the "doughnut hole" this year. They'll lose the government subsidy that's attached to the standard Medicare drug plan when their prescription costs reach $2,250. For the rest of the year, they'll have to pay 100 percent of their own drug costs until they've paid $3,600, when catastrophic coverage kicks in.

"People who are taking large amounts of medicine are hitting that area now," said Nancy Ogle, executive director of Senior Centers of Spartanburg County. "So it's going to put a lot of people into difficulty because many of them are seniors who are above the poverty line but just don't have that much expendable income."

At first Pat Ruff, director of the Senior Life and Wellness Center in Spartanburg, said the new drug plan was saving her mother, Virginia Anderson, nearly $300 each month.

"It has helped tremendously," Ruff said.

A quick phone call to her mother, however, changed Ruff's mind.

She was surprised to learn

that this month her mother hit the coverage gap and now has to pay all medication costs by herself.

"Well, I know they said there'd be a gap," said Anderson, who is 85 and lives in Cooley Springs. "I didn't know I'd hit it that quick. See, this is just October, and I've got the rest of the year yet."

Ruff said her mother's monthly bill is around $300 or $400, meaning she could pay more than $1,000 out of pocket this year.

"That's a lot of money," Ruff said. "… And yo•know, the drug companies and the government did not explain that."

Anderson said she could pay for it but it would take a large chunk out of her Social Security check. She added that she'd look into choosing a different plan next year, but plans with no coverage gap also have higher monthly premiums.

Spartanburg resident Herb Kay, 92, fills three prescriptions each month and said he doesn't need to worry about the coverage gap because his plan has lowered the costs of his medications.

"I'm quite pleased with mine," Kay said. "It's nicely low compared to what I was paying before."

Agnes Darling, 73, had problems signing up for her plan -- "it was a mess" -- but said things are going smoothly now. She's saving a lot of money through the new plan: One of her medications has dropped from $185 to $75 each month.

"So far I'd say my worry is how much more is it going to go up," Darling said. "The drug companies are making much too much money."

Rita Kirby, 57, also had problems getting signed up.

"It took me forever on the telephone to get all that straightened out," she said.

But everything's fine now. She said she wouldn't be able to afford her 12 medications if not for the new Medicare benefit. One prescription that used to cost her as much as $600 each month is down to $3 each month through her new plan.

"I do think it's a really good thing that we do have that plan," Kirby said. "It really helps out with your drugs, and I'm on a whole lot of medicine."

Kirby, however, hasn't hit the doughnut hole.

Anderson, who has, takes the opposite view.

"I don't think the government helped us any much," she said. "Not too much if you'll only pay so much then yo•have to pay full price."

Emily Dagostino can be reached at 562-7221, or emily.dagostino@shj.com.