>Wow! Where's that from, Mary?
http://www.news-medical.net/?id=2832
Lots of chatter about it in the news. sounds like it will cover the
injectables like Enbrel and Humira. Here is the Seattle Post
Intelligencer article on it:
Medicare project widens drug coverage
Program finances self-injections
By LARRY LIPMAN
COX NEWS SERVICE
WASHINGTON -- Medicare will begin paying later this year for certain
oral cancer drugs and intravenous drugs that can be self-administered
under a $500 million demonstration project unveiled yesterday.
About 50,000 people will be selected nationwide to participate.
Roughly half of the participants will be cancer patients, the others
will have chronic conditions such as multiple sclerosis, rheumatoid
arthritis, Hepatitis C and pulmonary hypertension, which are treated
by intravenous drugs administered by a health care professional.
Currently, Medicare does not pay for intravenous drugs unless they are
administered in a doctor's office, hospital or outpatient center. The
project will cover those drugs and certain newer, more effective
medications that will replace oral cancer drugs already covered.
The project is designed to demonstrate whether Medicare will save
money by covering drugs that can be administered at home. It also will
be a trial run for the Medicare prescription drug benefit, which is
scheduled to take effect in 2006. The demonstration project will end
Dec. 31, 2005.
Under the program, beneficiaries would pay for their drugs using the
benefit structure adopted by Congress last year in the Medicare
Modernization Act. Under that structure, a beneficiary would pay a
$250 deductible and then 25 percent of drug costs up to $2,000. After
a beneficiary had spent $3,200 in out-of-pocket costs, Medicare would
pay all but $5 for a brand-name drug and $2 for a generic drug.
For example, a breast cancer patient who now pays $1,642 a year for
Tamoxifen would pay $536 under the program, a savings of $1,106. A
multiple sclerosis patient who now takes a battery of four drugs with
an annual cost of $16,298 would pay $4,038, a savings of $12,260.
Low-income beneficiaries would save even more.
The project will be limited to beneficiaries who do not have other
drug coverage and who receive a form from their doctor certifying
their need for the covered drug. Applications will be handled by a
private contractor, TrailBlazer Health Enterprises, which was selected
to administer the project.
Medicare beneficiaries who qualify can begin applying July 6.
Applications will be available at www.medicare.gov or by calling
1-866-563-5386.
Medicare will select by lottery 10 percent of those who apply by Aug.
16 to begin receiving benefits starting Sept. 1.
The rest of the beneficiaries will be similarly selected from those
who apply by Sept. 30.
Under the guidelines set by Congress, 40 percent of the money -- or
$200 million -- must be spent on covering cancer patients.
The lottery will divide all applicants into two pools: one for cancer
patients and one for non-cancer patients. Applicants will be selected
by alternating between the pools until the cost of the cancer pool is
projected to be $200 million, or until 50,000 applicants have been
selected from the two pools combined.
Visit my website:
http://www.mzuschlag.com
Harvey R. Stone - 27 Jun 2004 14:22 GMT
Thank you for posting it Mary and thanks to the Democrats in the senate that
believe the people are more important than who is in power.
Harv
> >Wow! Where's that from, Mary?
>
[quoted text clipped - 70 lines]
> Visit my website:
> http://www.mzuschlag.com
Mary Z - 27 Jun 2004 14:34 GMT
>Thank you for posting it Mary
Here is the link to the government site application form etc.
http://www.cms.hhs.gov/researchers/demos/drugcoveragedemo.asp
Visit my website:
http://www.mzuschlag.com
PEPPER1960 - 29 Jun 2004 23:32 GMT
I e-mailed this to foreign friends who thought it was a disgrace that health is
treated like a "prize" in the US.
Mary - 30 Jun 2004 00:35 GMT
>I e-mailed this to foreign friends who thought it was a disgrace that health is
>treated like a "prize" in the US.
An English friend of mine didn't see that Medicare was doing it, but
assumed that it was a drug company marketing scheme.
That said, not everyone in countries with government-funded universal
health care can get Enbrel, either; there's some sort of rationing
system somehow.
I'm pretty much all for universal coverage of some sort, but *someone*
has to pay for the drugs, for the research, and there's just not going
to be enough money to let everyone who can't afford medicine get
exactly what they need.
-
Mary MacT
http://www.alamedacreek.net
Jo Firey - 30 Jun 2004 01:55 GMT
> I e-mailed this to foreign friends who thought it was a disgrace that health is
> treated like a "prize" in the US.
We have a lot of rights and a lot of freedoms, but we do not have the right
to health care in this country. The majority would like it, but the
majority is not willing to pay for it. And it is complicated by the fact
that if you have the means in the US you have access to pretty good health
care just about on demand. Those that are in that position are nervous
about what would happen if everyone had total access. There isn't enough to
go around.
Jo
PEPPER1960 - 06 Jul 2004 00:47 GMT
I don't mind paying for my medical care, but the price of it and drugs in this
country is not reasonable. I will glaly pay a reasonable price. I do not
believe the high prices pay for research, it merely pays for more marketing.
Mercy - 06 Jul 2004 01:26 GMT
One of my dearest friends I met on ASA was called Peppergirl and she died
2.5 years ago because of complications. I thought I saw a ghost when I saw
your name.... Gasp!!! Sorry!!!
Nettie
> I don't mind paying for my medical care, but the price of it and drugs
in this
> country is not reasonable. I will glaly pay a reasonable price. I do
not
> believe the high prices pay for research, it merely pays for more
marketing.