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The Baltimore County Department of Aging has posted two files to their Web site that evaluate Senate Bill S.1 and House Bill 2473. The first file is a comparison of both bills on a grid and the second file is a written critique of both plans. Both evaluations can be viewed at www.smartrxcard.com/news.htm. The comparison grid makes it easy to see which Senators and Congressmen have sponsored the two bills. It compares the premiums, deductibles, co-pays and the total out-of-pocket costs a consumer will have to pay at $2,000 of total medications and at $5,800 of total medications. The comparison grid also shows how each version of the bill would deal with catastrophic prescription costs. The written critique clearly shows that the House and Senate bills estimate that the premiums for prescription drug card coverage would be approximately $35 per month or $420 per year. In the Senate version, benefits would not start until the individual spent $275 in deductibles or $250 in the current House version. A couple using the Senate version will pay $840 in premiums and $550 in deductibles before receiving any benefit. The Senate version will pay only 50% of the cost of medications between $276 and $4,500. The House version would pay 80% of the cost of medications between $251 and $2,000. This means the individual will pay $2,112 for prescriptions at this level of coverage under the Senate's plan and only $350 under the House's plan. The coverage gap occurs between $4,501 and $5,800 of medication costs in the Senate bill and $2,001 and $4,900 in the House Bill. There is "no coverage" at this level of either plan. This will cost the individual another $1,299 in prescription medication costs under the Senate Bill and $2,899 under the House Bill. The Senate Bill will cover 90% of the costs over $5,801 and the House version would cover 100% when spending goes over $4,901. The conclusion is that an individual will have to spend $4,106 under the Senate Bill before benefits reach the maximum of 90% and $3,919 before the House sponsored bill starts paying 100% of prescription medication costs. A couple using the Medicare prescription solution will spend $8,212 under the Senate's plan and $7,838 if the House plan gets passed. In addition, Congress wants to restructure Medicare so that it is run by private insurance plans. While the House and Senate propose average premiums of $35 monthly, private insurers will set the premiums at whatever price that they determine as long as the benefit meets an "actuarial value" of a standard coverage plan. This means that the insurance company will be able to charge whatever they want as long as they can prove that the benefit "justifies" the cost. Private insurers will only have to guarantee coverage for two years. Coverage may be dropped after that, leaving consumers to find coverage somewhere else.
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