A Senate bill intending to improve Medicare Part D coverage would still leave AIDS patients stuck in a coverage gap or "doughnut hole" for prescription drugs, say advocates. Medicare is the health coverage provider for about 100,000 AIDS patients. The Part D program was created to cover much of the cost of prescription drugs.
When total drug costs reach $2,510, the doughnut hole begins and AIDS patients have to spend $4,050 out-of-pocket before Part D coverage resumes. However, AIDS Drug Assistance Program (ADAP) expenditures do not count toward meeting that out-of-pocket threshold, leaving many AIDS patients unable to get out of the coverage gap.
Due to California's budget crisis, ADAP already faces proposed cuts to its formulary. In addition, ADAP covers HIV medications but not drugs used to treat high blood pressure, cancer, diabetes, and other conditions that occur more frequently among those living with HIV.
"Congress has turned its back on people with AIDS by failing to address their needs," said Kali Lindsey of the National Association of People with AIDS.
"In California, most people with HIV/AIDS receive two months of partial coverage under Medicare before they go into the doughnut hole," said Anne Donnelly of Project Inform, which with San Francisco AIDS Foundation is calling on Congress to solve the problem.
AIDS advocates say there is bipartisan support to rectify the issue in the Senate Finance Committee, but its chairperson, Sen. Max Baucus (D-Mont.), is bringing the bill to the full Senate without a committee vote. The House version fixes the problem, but it is unclear whether that measure's language will be included in any final bill passed in conference between the chambers.
06/12/08
UNITED STATES: AIDS Coverage Gaps Linger in Medicare
Source: Bay Area Reporter:: Bob Roehr; Courtesy of the CDC National Center for HIV, STD, and TB Prevention