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    Avoiding the (Medicare) “Doughnut Hole”

    Depressed Medicare beneficiaries in the so-called coverage doughnut hole were more likely to cut back on their antidepressants than those who had full insurance coverage, a study has found.

    Even with the Affordable Care Act (ACA) – Obamacare by any other name – in place and affirmed by the Supreme Court, the costs paid and lifestyles lived by many is being tied to the “doughnut hole.” This is especially true for seniors taking depression medications.

    As recently reported in Med Page Today, a new study by Yuting Zhang, PhD, of the University of Pittsburgh, Medicare may not fully cover depression medications for seniors, despite the ACA. The article is titled “Antidepressants 'Fall' Through Doughnut Hole.”

    If you are unfamiliar with the “doughnut hole” issue, you are not alone. It is the coverage gap created by Medicare Part D. For those whose income is at the lower end, there tends to be coverage. Likewise, for those who have an upper-end income, there is still coverage…with a gap in between.

    According to the new study, and sheer intuition, patients that fall within the doughnut hole are associated with a significant drop in medication use – 12% on average. That is always relevant, but perhaps especially so in the case of depression medication. While discontinuing any prescribed medication is never advisable, it is often easier to justify foregoing depression medication than other medications.

    I recommend reading the original article for more details regarding this study, should this issue be relevant to you or someone you love.

    Contact Meier Law Firm to discuss how we can help you protect everyone you love.

    Reference: Med Page Today (July 5, 2012) “Antidepressants 'Fall' Through Doughnut Hole

    Elder Depression – Preventative Assistance

    

    Depressed people are more likely to receive diagnoses and be treated in primary-care settings than elsewhere. Research shows that elderly people, in fact, prefer to deal with their primary-care provider on mental health issues. In that context, coverage of depression screening may help more Medicare beneficiaries get the help they need.

    As of last October, Medicare began coverage for a host of preventative services as part of the new healthcare law. One such service for the elderly is depression screening.

    This subject was recently addressed in a Kaiser Health News article, and it’s worth reading to learn more.

    The mind/body relationship is a complex one. It is hard to deny the overall health effects of depression, perhaps even more so among the elderly.  However, contrary to popular opinion, the elderly are not statistically more prone to depression than the general population.

    On the other hand, the elderly are more prone to types of system-wide health difficulties that may be exacerbated by depression. To make matters worse, people of the elder generations are generally less trusting of psychology and associate a social stigma with mental illness or any admission thereof. The combination of these two factors often, and unfortunately, complicates the lives of elderly persons and their families.

    Medicare now covers the cost of annual depression screening in primary-care settings with no cost sharing for beneficiaries. Medicare also covers 60 percent of the treatment for mental health problems, including depression. (Under a 2008 law, that figure is scheduled to rise to 80 percent in 2014.) If you or an elderly loved one may be suffering from depression, taking advantage of Medicare’s annual screening benefit may be a good idea and can greatly improve quality of life.

    Reference: The Kaiser Health News (April 3, 2012) “Medicare Now Covers Annual Screening For Depression




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