Health Care Law Improves Prescription Drug Coverage

Leahy and Sanders Announce 9,000 Vermont Seniors to Receive $250 Rebate

BURLINGTON, Vt., – U.S. Sens. Patrick Leahy (D-Vt.) and Bernie Sanders (I-Vt.) announced today that almost 9,000 Vermont seniors will receive a one-time $250 rebate check beginning this week as the new federal health care law begins to close a gap in Medicare coverage for prescription medicine.

The first checks will be mailed June 10 for people whose out-of-pocket expenses already total more than $940 for the year, the senators said during a joint press conference at the Champlain Senior Center. People covered under Medicare Part D should receive a check automatically.

Nationwide, more than 3 million people a year fall into the so-called doughnut hole, the gap in coverage for drug costs between $2,830 and $4,550. 

Starting in 2011, people affected by the coverage gap will receive a 50 percent discount on brand-name drugs.  By 2020, the doughnut hole will be eliminated entirely. In addition, starting in 2011, increased discounts for both generic and brand-name drugs will save seniors more than $700. The savings will grow to more than $3,000 annually by 2020.

Rep. Peter Welch (D-Vt.) supported the health care reform bill in the House of Representatives.

The health care law signed on March 23 by President Barack Obama also made the program more secure and more affordable by curbing excessive Medicare Advantage payments to private insurance companies, by cracking down on fraud and abuse, and by increasing the Medicare payroll tax on the wealthiest Americans.  It is estimated that Medicare premiums will drop by $45 per year for 80,000 Vermont seniors thanks to better oversight of the Medicare Advantage program.

Among other improvements, there no longer will be deductibles or co-payments required for an annual checkup or for other preventive services. For low-income seniors, access to no-cost drug plans will be expanded and co-payments will be eliminated for those on Medicare and Medicaid who receive home and community-based care. 

Leahy and Sanders were joined at the press conference by Greg Marchildon, AARP’s Vermont state director. While many members of the nation’s largest senior citizens organization are too young to qualify for Medicare, the new health care law offers benefits to those in their 50s and early 60s who retire early.  A new program that began June 1 will benefit 6,000 Vermont retirees with health insurance through their former employers.  To encourage companies to continue health care coverage, their former workers are eligible to be reimbursed for up to 80 percent for claims from $15,000 to $90,000 per person.   

The Vermont senators played leading roles in shaping other parts of the health care law.

Under a Sanders provision cosponsored by Leahy, affordable primary health care will be dramatically expanded through community health centers like the eight already serving more than 100,000 Vermonters.  Among them are 20 percent of those over 65 who get their primary care at community health centers.

Leahy led the charge, with support from Sanders, to make certain that Vermont will get an estimated $100 million to $300 million in additional Medicaid reimbursements over the next decade. The increase means Vermont will not be penalized for expanding Medicaid coverage to more people before the new health care law took effect.

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