I enjoyed getting together with you and hope you might help me inform others about the free online resource on medicare.gov, the Medicare Plan Finder which teaches people on Medicare how to lower the cost of their medicines. My 27 years of experience as a general internist in suburban Atlanta led me to establish a nonprofit 501(c)(3) (approval pending) educational website, www.medicaredrugsavings.org, which teaches people how to navigate the Medicare maze and utilize the Medicare Plan Finder.
In 2009, my 75-year-old mother was diagnosed with lung cancer. Her Medicare drug plan did not pay for the Tarceva, which cost $1,500/month (2013 retail price >$6,500/month). Our family was able to afford this. Unfortunately most people do not have the resources to deal with this type of situation.
Many of the 55,000,000 people on Medicare struggle to pay for their medicines, despite the existence of the Medicare D and Advantage programs, which help cover the cost of medicines. Fortunately, a resource on www.Medicare.gov helps address this problem.
The out of pocket costs to cover a specific set of medicines for a person on Medicare D or Advantage vary significantly between plans. A 2012 study demonstrated average annual savings for a person on Medicare D would be $368/year if the least expensive Medicare D plan covering a specific set of medicines was chosen. It was shown that only five percent of the Medicare population chooses the least expensive plan. Given the many available plans (over 50 in metro Atlanta), this is not surprising. For many people the savings can be much greater.
Extrapolating this $368/person savings to the entire Medicare population yields a potential annual savings of $20.2 billion (>$485 million in Georgia). It is estimated that the Federal and state governments, which subsidize costs for people with lower incomes, could save $5 billion annually.
Many initiatives aim to improve health care for veterans. The 2012 US census reported that approximately 9.7 million veterans aged 65 or older are covered by Medicare. Approximately 4.5 million veterans in this age group received care from VA Health Care and/or Tricare. Extrapolating the $368/year to the remaining 5.2 million veterans in this age group yields an annual savings of $1.91 billion. This does not include additional saving for veterans on Medicare who are younger than 65, the veterans’ spouses who are covered by Medicare or the 20 percent of those eligible for care at the VA who select Medicare Advantage plans (p. 31).
The Medicare Plan Finder is an interactive tool on www.medicare.gov which permits users to input their medicines and obtain a detailed report showing the estimated out of pocket costs for all of the available Medicare D and Advantage plans. Few people are aware of this resource. Every year a number of informative articles in the New York Times, Forbes, and other publications discuss this tool. Unfortunately people who do not see these articles are unlikely to know about it. In addition, many patients on Medicare do not have the computer literacy necessary to utilize it.
I have been trying to publicize this since 2012 when an elderly patient said that she was losing her house to foreclosure because she had to choose between paying for her medicines and her mortgage. It took me four minutes to show another patient that a planned Medicare D change would cost an additional $31,000/year. An oncologist explained to me that none of the Medicare plans in our area covered the medicine prescribed for my mother; he said his patients could only take it if he could obtain donations from a pharmaceutical company. I used the Medicare Plan Finder to show him in several minutes that a number of plans did cover this medicine, lowering the cost in 2013 from $79,000 to $6,000/year.
The November issues of ACP Internist (newsletter for the 143,000 members of the American College of Physicians) highlighted this resource as well as my attempt to publicize it. I was recently asked to present this information at the Medical College of Georgia.
In the last three years, I have spoken to many organizations as well as hundreds of patients and physicians about this topic. Two patients (and no physicians) were familiar with the Medicare Plan Finder. Unfortunately my experience has taught me that just educating doctors and nurses is not going to adequately reach the people who would benefit from this and that there is a need for a focused educational initiative aimed at the public. I hope that you and some of your colleagues in your field would be interested in supporting this.