The last month and a half of 2009 was Medicare “open season,” when Medicare enrollees attempted to navigate the maze of prescription drug plans to find the one that will best meets their needs in 2010 . Legal Aid and Whitman-Walker staff, together with a host of incredible volunteer attorneys, spent this time running a series of Medicare Part D Clinics to assist clients through this complicated and tedious process. Through the efforts of our volunteers efforts and those of Legal Aid and Whitman-Walker staff, we were able to serve 348 clients -- 133 through Legal Aid and 215 through Whitman-Walker. Behind these figures seniors persons or living with a disability who would not have been able to get their drugs without help. These are just a few examples of the lives that we touched:
- A Legal Aid client was taking several prescription drugs that were not covered under any low-income subsidy plan. A volunteer did her drug analysis and then phoned her doctors to discuss whether there were medically equivalent alternatives that would be covered under one of these plans. He got through to her doctor, spoke with him and the client is now going to be able to get the prescriptions she needs through a plan that will not charge her a premium. With income of less than $700 per month, payment of any premium would have been a hardship.
- Another Legal Aid client was very concerned about switching plans even though the plan she was in would have charged a premium. This client faces challenges with literacy and memory as well as very low income so the premium payment would have been a problem. A volunteer did her drug analysis and identified a plan that would have covered all of her drugs without restrictions or a premium. Despite the client’s reluctance and the fact that she was hard to get a hold of, the volunteer spoke with the client repeatedly and patiently explained her options to her. Through her patience and perseverance, she was able to convince the client to change to the better plan.
- A Whitman-Walker hearing impaired client with HIV and severe mental health issues was taking a mental health medication that none of the low income subsidy plans covered and planned to move back to Florida to be closer to his family after the new year. A volunteer analyzed plan options for both DC and Florida to find a plan covering all his medications with very low out of pocket cost that was accepted in DC as well as Florida. The volunteer also coordinated new applications for the Florida Medicaid and QMB programs.
- A Whitman-Walker client living with HIV was unable to attend a clinic as she was out of state caring for her mother during open enrollment. In researching her plan options, it was clear that her 2009 plan would no longer cover one of her medications, Ribavirin. If she stayed in the plan, her annual out of pocket cost for medications would exceed $10,000, while her annual income is just under $12,000. Even when Ribavirin was covered, most low-income plans required prior authorization before they would pay for it. After some research, we secured a $0 premium plan that covered all of her medications, including Ribavirin, without burdensome restrictions and an annual pocket costs of only $113.
These stories are only a few of the many people who were helped through these clinics. Many times during these clinics clients expressed their thanks and their incredible sense of relief to have an advocate knowledgeable about this complicated process to guide them through this important choice. We are very grateful to all of our volunteer attorneys for their time and dedication. Thank you!