SENIOR Q&A: Is the Medicare Part D "doughnut hole" closing?

Q: This is my first year on Part D and I find myself in the "doughnut hole" situation. I thought I read somewhere that this gap in coverage will be eliminated in 2020. Can you confirm?

A: The so-called "doughnut hole" situation with Medicare Part D benefits, according to AARP's website, refers to "Part D beneficiaries who have high prescription drug expenses (who) currently have to pay more once the total cost of their medicines reaches a certain threshold. That’s due to a quirky aspect of Part D called the coverage gap, also known as the "doughnut hole. The "doughnut hole" has been narrowing each year since the Affordable Care Act (ACA) was passed in 2010. Originally the gap was scheduled to close in 2020, when beneficiaries would be expected to pay 25 percent of the cost of all their prescriptions while they were in the gap."

Recent legislation will close that gap earlier, in 2019 for brand-name drugs and in 2020 for generic drugs. This is good for the many seniors who had to pay a much higher amount for their prescriptions.

Q: My daughter is getting married in the fall and my mother who lives locally would like to come. My mother moves slowly, is unsteady on her feet, has vision problems, and does not hear well. I want my mother to see her granddaughter get married, however I am not sure given my mother’s needs this will work out. My family members refuse to lend a hand. Any ideas?

A: You can call a home care agency and hire help for your mother. The private aide can wear wedding attire and stay close to your mother to allow her the dignity and respect, so she does not stand out. An aide in scrubs would stand out and your mother may be uncomfortable with that. Some home care agencies have aides that are drivers and they can drive your mother to the event, stay with her, drive her home, and help her get undressed and ready for bed. This way if your mother cannot stay for the entire wedding party she has a way to leave without the burden falling on you. This is a day you should be with your daughter and her new family. Your mother may be resistant to having help, so consider having the aide meet your mother before the big day to get to know one another. Have the aide come to the house and spend a few hours either chitchatting or helping out. This is the time you can talk to the aide about her role. Then on the day of the event the aide is a familiar face. The added bonus is: if your mother likes the aide maybe she would consider having her come weekly into her house to be of assistance with care or with cleaning, laundry etc

Q: My father has poor eyesight and he wants to stay at home. He is sharp and able to manage but he has difficulty with his pills and using his phone. Any suggestions?

A: Most pharmacies today can print prescription information sheets in large print and they can print the labels on the bottles in a larger print if you request it. Walgreens offers a "talking pill reminder," (which is free to Walgreens customers who have visual impairments or are blind). The pharmacist records the information orally that is on the prescription label. This device attaches to the bottom of prescription bottle and it speaks the information. There is also an audible alarm to remind people to take their medications. CVS offers Scriptalk which is similar to Walgreens' service. As far as using the phone, it can be difficult to see. There is a device called the "voice dialer" and it is available for free to anyone who is legally blind. The phone is through the Massachusetts Distribution Program. For anyone who is legally blind there is an application that needs to be completed and signed by the doctor. For anyone who has low vision but is not legally blind, the device can be purchased for $229. There is a company here in Massachusetts called Visions of Independence that specializes in such technology. They can provide an assessment with an occupational therapist who specializes in helping low-vision patients and can make suggestions about how to modify and adapt the home.

Linda Sullivan RN, CMC and Debbie Gitner LCSW, C-SWCM are geriatric care managers/aging life care professionals. Each has had more than 35 years of experience working with the geriatric population in acute and long term care setting. Both are certified court mediators and have completed the educational seminar "Alzheimer’s Disease and Dementia Care." Together they started a business called ElderCare Resource Services which is a company that can assist, advocate, and help families through the medical maze of best options for their family member.