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Uncapped Medicare costs are squeezing consumer pocketbooks

Prescription Drug Costs DaraprimAs the American health care affordability crisis continues to unfold, many consumers have struggled to pay for expensive prescription medications. Even seniors and those with disabilities qualifying for Medicare, the federal health insurance program, struggle to cover the costs.

Medicare Part D provides consumers financial benefits. Consumers are expected to pay 25 percent of their total medication costs until those expenses reach $5,100 for the year. Once expenses reach $5,100 annually, they cover only 5 percent of their medication costs.

For some consumers, even that 5 percent is too much. NPR affiliate, KALW Radio, recently shared the story of 66-year old Tod Gervich, a self-employed financial planner. He uses a drug called Copaxone, which helps keep his multiple sclerosis in check. By March, Gervich hit the $5,100 threshold, and Medicare Part D subsidies lowered his monthly fee to $295. That’s still too much for his budget.

“I feel like I’m being punished financially for having a chronic disease,” Gervich says. He has considered discontinuing his medication to save money and cites his drug costs as a reason for not retiring. He joins more than 1 million Medicare patients with Part D plans who did not receive low-income subsidies and had drug costs that pushed them into catastrophic coverage in 2015.

Medicare Part D is different from Medicare Parts A and B in that it does not have a yearly spending cap.

Are you a Medicare patient who struggles to pay for your prescription medications? Share your story with Voices for Affordable Health. #myvoicemyhealth