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New twists in drug coverage explained

Daniel Moraski of the Social Security Administration spoke about his department’s programs at the Holland Senior Center Monday. Christopher Tanguay. (click for larger version)
July 27, 2010
HOLLAND — Watch out for the doughnut hole.

That was just one of the tips discussed by SHINE — Serving the Health Information Needs of Elders — Regional Director Alicia Germain of the Department of Elder Affairs during a presentation at the Holland Senior Center Monday on what kinds of disability and retirement benefits are available for seniors through programs like Medicare and Social Security.

Discussing Social Security was Daniel W. Moraski of the Social Security Administration.

The doughnut hole, Germain explained, is a gap in prescription drug coverage that many people find themselves stuck in when their annual medication costs exceed $2,830 — between out of pocket fees and the percentage picked up by one's insurance carrier.

"When your drug plan stops helping, you fall into what they call the 'doughnut hole,'" Germain said.

If prescription costs reach the $4,300 threshold, or the "catastrophic," range in the eyes of an insurance provider, Germain said, coverage may kick in again, though many people who exceed the $2,830 do not always reach $4,300 and are therefore left to fend for themselves to pa for their necessary medications.

Germain explained certain provisions of Medicare, like the Advantage plan, can help people with staggering prescription costs by lowering premiums and co-pays.

Additionally, for the rest of 2010, anyone who falls into the doughnut hole will automatically receive a one-time payment of $250 to help with prescription costs.

See Wednesday's Southbridge Evening News for complete coverage of community news.

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