In a public-private partnership to help thousands of seniors struggling to pay for prescription drugs, Gov. Martin O'Malley plans to announce today a deal with CareFirst BlueCross BlueShield to help cover those caught in a Medicare gap.
The agreement would help seniors bridge the "doughnut hole," a much criticized cost-saving measure built into the Medicare prescription drug benefit passed by Congress in 2003. The program covers annual prescription costs up to a certain amount and costs above a higher threshold, but not those in between, leaving a hole in the middle of the coverage plan.
Critics of the system say that seniors who fall into the gap often go without medications because they can't afford them, leading to more illness.
"Too many of our neighbors, especially our seniors, are still forced to choose between taking their prescription medications and putting food on their table," O'Malley said in a statement.
The governor plans to announce the program today during an appearance at a Baltimore senior center with Mayor Sheila Dixon.
An estimated 3 million seniors fell into the coverage gap last year. The proposed Maryland subsidy, which would require legislation in the General Assembly, would help an estimated 7,500 lower-income residents. CareFirst has pledged to cover the cost of the $7 million annual program; no state funding would be needed.
The Maryland subsidy would cover seniors with incomes including Social Security benefits and retirement plans up to 300 percent of the federal poverty level, or about $42,000 for a couple. The amount of the subsidy would depend on how far into the doughnut hole seniors fall. About half of those who would qualify have costs not covered by the current plan of less than $500, but about one in six pays $1,500 to $3,000 for drugs that the subsidy would cover.
CareFirst also provides a $25-a-month subsidy to help lower-income residents cover Medicare drug plan premiums. Several other states have similar programs to help the elderly afford prescription drugs and to mitigate the effects of the doughnut hole.
"These are elderly folks who need their drugs and have limited means," said Chester Burrell, chief executive officer of CareFirst, the region's largest insurer. "People literally run out of funds, and they find it very difficult to pay for their drugs."
