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Budget Cuts Could Hamper GAPS Program

In the Middle

Many South Carolina residents who are on a Medicare Part D plan know all too well what the “donut hole” is. The “donut hole” is the financial point where a participant has to pay 100% percent of the cost of their prescription drugs. For some individuals, this coverage gap can be financially devastating.

The state of South Carolina has, in recent years, provided additional help to those who met particular income guidelines. The SC Silver Card (no longer in existence) debuted in the early 90’s to assist individuals with the cost of their prescription drugs. Once the Part D plans were introduced a few years ago, the South Carolina Department of Health and Human Services created the GAPS program as a replacement for the SC Silver Card plan. GAPS was designed to assist those who fall into the Part D coverage gap with their prescription drug cost by covering 95 percent of the out of pocket cost. It was looked to as a model for other states as a way assist individuals with these costs.

During the 2008 state budget cuts, SCDHHS reduced the 2009 benefit from 95% coverage of the “donut hole” to 10% coverage.South Carolinalawmakers worked to restore the benefit for the state budget starting July 2009.

Fast forward

Despite lawmakers’ good intentions to help lower income seniors cover their drugs costs, the state’s continuing severe economic woes have siphoned away the money.

A story in the July/August Bulletin heralded AARP South Carolina’s successful push to have funding partially restored to a program that covers 95 percent of the cost of drugs for those who fall into the “donut hole” coverage gap. While lawmakers voted to restore the funding for the current fiscal year, which started July 1, it wasn’t possible to do so until the start of a new calendar year. Meanwhile, in the state with the nation’s third highest unemployment rate, the Department of Health and Human Services suffered deep budget cuts and is certain to face future cuts.

Anyone taking prescription drugs, not just those with Medicare Part D coverage, can learn more about the donut hole and how to find lower-cost versions of brand name drugs. .


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