Medicare Part D

CURE, Fall 2007, Volume 6, Issue 5

Medicare part D turned into a financial nightmare for retired New York City civil servant and ovarian cancer survivor.

Layzer, 66, has ovarian cancer, first diagnosed in 1971. Her ongoing cancer treatment costs, including expensive daily injections of a hormonal drug typically used to treat infertility, were covered by her employer through Group Health Incorporated (GHI), a New York health insurer. That medicine and three other hormonal drugs control the growth of her tumor, Layzer says.

After initially receiving the drug for free as part of a medical research program, Layzer paid a $40 monthly co-payment for the injection until Medicare Part D came into effect on Jan. 1, 2006.

Figuring she would receive the same coverage, Layzer decided to keep GHI as her primary prescription drug provider under the new Medicare drug program. “My union suggested I stick with them,” she says.

But Medicare Part D refused to pay for the expensive drug for a cancer diagnosis, so Layzer’s retiree medical coverage paid 75 percent and charged her a 25 percent co-payment, making her out-of-pocket costs for the drug jump to a staggering $7,300 a month, she says.

“I have gone through my savings, cashed in my life insurance policy and asked for help through friends and relatives,” says a frustrated Layzer. “The whole purpose of the Medicare drug program was to cover high costs.”

At press time, Layzer had found a solution for now — coverage through February 2010 from her deceased husband’s former employer. She pays a $294 monthly premium plus a $50-a-month co-payment for the medicine in question.

Medicare Part D turned into a financial nightmare for retired New York City civil servant J. M. Layzer.