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The Disadvantages of Medicare Part D

Any one that has Medicare may also apply for Medicare Part D prescription drug coverage. To get Medicare drug coverage, participants must enroll in a Medicare drug plan. Plans vary in cost, the prescription drugs covered and between states. The purpose of Medicare Part D is to assist senior citizens in affording the medications that they need. While Part D has certainly helped some seniors, research from Samford University in Alabama and other reliable sources have found it to have its disadvantages, too.

  1. Complexity

    • The varying drug plans available, and the ever-changing nature of the plans, means that drugs that were covered under a plan one year, may not be covered by the plan the next year. This means that seniors must do extensive research each year to ascertain which plan covers the medications they need. This is confusing and time consuming and, particularly for those seniors that are not computer and Internet savvy or do not have access to the Internet, finding the right plan can be difficult. Seniors that choose the wrong plan have to suffer with it until they get the opportunity to change plans again the following year. This confusion is not only difficult for seniors, but doctors and pharmacists are finding it difficult to keep track of changes in the individual plans.

    Donut Hole

    • There's nothing sweet about Medicare Part D's donut hole. Part D will only pay for a certain amount of drug coverage annually. This amount varies according to the plan. As of 2010, the average amount was $2,830. Once Medicare has purchased that amount of drugs for a participant, coverage stops and the participant must then pay for his drugs himself. This period is known as the donut hole. Once out-of-pocket costs reach $4,550, Medicare Part D starts paying again. The donut hole period can be dangerous for a participant and jeopardize his health, if he has to stop taking his medications because he cannot afford them.

    Exclusions

    • Many common prescription medications are excluded from Part D plans. This means that a participant who was responding very well to a certain drug may have to be prescribed an alternative, which may not be as effective. The alternative may also not be compatible with the other drugs the person is taking. Doctors may request a drug plan to make an exception in a specific case, but this can be time consuming and is not always successful.

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