High Cost Of Prescription Drugs For Seniors
(Column: Ask the Pharmacist)
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In this month's article I want to talk about the high cost of prescription drugs and the problems it has caused many of our senior citizens. Most of us are aware of the outrageous prices pharmaceutical companies charge for many medications. Why these prices are so high and how the pharmaceutical industry gets away with charging these prices would probably be a good topic for another article. This month I want to discuss what senior citizens who are on a limited income and have no insurance coverage for prescriptions can do to help reduce the cost of their medications.

We have all read about the government talking about including prescription drug coverage in Medicare. I have read the proposals by Mr. Bush and Mr. Gore and while I like Mr. Gore's proposals slightly better, I found them both to be too complex and too expensive. Also, the thought of the government running this program seems like it could become a beaurocratic nightmare. Even if it does get passed, I believe it is still quite a few years away before patients will have it included in their benefits.

Many seniors when they retire lose their health benefits received from their jobs. Most of them could continue their insurance policies, but would have to pay for them out of their own pockets and the cost is usually too high. Besides, Medicare kicks in at age 65. The problem with Medicare is it does not pay for prescription drugs.

What many older patients don't realize is that there are options they have to get their medications covered. One option is patient assistance programs. We discussed this in a previous article. This is when a pharmaceutical company will provide medications at no cost if the patient has no insurance and cannot afford to pay for it themselves. The problem with this is not all medications fall into this category and if you are on multiple medications you must apply separately for each one. Also, there is no guarantee you will be accepted into the program.

A second option is many patients can enroll in a Medicare approved HMO. These HMOs offer the advantage of no copayments for doctors and hospitals and limited prescription drug coverage. The disadvantage of these programs is you are tied to the insurance company's rules and they usually have a cap on the prescription coverage. U.S. Healthcare, HIP and Oxford all offer such plans. Once you have exceeded this cap, which is usually between $500-$1,500 a year, you are back to paying full price for your medications.

In my opinion, the best option for senior citizens is a plan the state puts out called EPIC. EPIC is a plan put out by New York State to help senior citizens pay for their prescriptions. It is available to any New York State resident who is over 65 years old and has a joint income under $24,400 (by Jan. 1st, 2001, this will be raised to $50,000). Almost all prescription drugs are covered as well as insulin and insulin syringes. The cost of this plan is minimal. It could be as low as $8 per year. The only restrictions to this plan are your income must be under the cap set by EPIC and it is only available to patients who have no prescription drug coverage. If you want to sign up with EPIC you can get an application at most pharmacies or you can call them at 1-800-332-3742
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