At Risk of Elimination – MoRx Helps 226,000 Missourians Purchase Medication
Posted on April 27, 2011 by Megan Burke
Missouri’s prescription drug program for low-income seniors and people with disabilities (MoRx) is set to expire on August 28, 2011. The MO legislature could pass legislation (SB408) to extend the program, but they have yet to do so. The legislature has until the close of the legislative session on May 13th to pass an extension. In addition, the funding the Senate removed from the budget would need to be put back.
MoRx helps 101,000 people with disabilities and 125,000 seniors purchase their medications. Eliminating the MoRx program will essentially double the out-of-pocket costs for these individuals. When medication is not affordable, people often tend to take a reduced portion of the dosage ordered by the doctor so as to make the medication last longer or don’t purchase the medication at all. This creates a variety of health risks for the individual, which can lead to increased doctor visits, hospitalizations, loss of independence, and even untimely death.
V. has Medicare Part D and MoRx as coverage for her prescription medications. Without the help of both of those plans, her prescriptions would cost more than her monthly social security benefit (over $1,000/mo). V. is diabetic, has breathing problems, and experiences severe hip pain. She takes breathing medicine, insulin, prednisone, vicadin and other medications. In addition to those medications, she also pays out of pocket for 9 over the counter medications. V has worked all of her life, paid into the system, and raised her children without help. Now that she needs help, the system may not be there for her. V is not sure what will happen if MoRx is not there for her in the future.
To be eligible for MoRx, an individual must be enrolled in a Medicare Part D prescription drug plan, a resident of Missouri, and meet the income eligibility standards. Income eligibility standards are an annual gross income less than $21,660 for an individual and $29,140 for couples, or being eligible for both Medicare and Medicaid.
The MoRx program pays 50% of all out-of-pocket costs for medications covered by the Medicare Part D plan, including the cost of the deductible and co-payments. This benefit is particularly important when beneficiaries reach the doughnut hole (coverage gap) in Medicare. The Affordable Care Act has provisions to reduce prescription costs and eventually eliminate the coverage gap by 2020. In the mean time, low income individuals with disabilities and older adults need MoRx as a safety net.
If the Missouri Senate does not reauthorize the MoRx program and return the funding to the budget (which was included in the Governor’s and the House’s budget proposals), 226,000 individuals will see a doubling of their out-of-pocket medication expenses. Providing assistance to preventive services such as medications reduces other more costly services such as hospitalizations, etc.
“An ounce of prevention is worth a pound of cure.” – Benjamin Franklin