To save money for the province, the Alberta United Conservative Government (UCP) reversed the Seniors Drug Benefit Program in 2019. The decision affected the lives of over forty-thousand Albertans and saved as much as 36.5 million dollars each year since. However, the change also means some people have been kicked off their medical coverage plans.
It is a common trend that has been occurring and is even accepted by some. Elderly folks who need specific medications and prescriptions are kicked off their spouse's coverage plan and have to find another way to pay for it.
Marilyn Witwer is a senior from Airdrie who says she was kicked off her husband's coverage plan and has to work so she can afford her prescriptions and medications.
“I pay somewhere around 100 dollars a month, and that's not 100 per cent coverage. I have a lot of health issues. I'm on a fair bit of medication, which is fairly expensive.” says Witwer.
If she wants to retire, Witwer says she will need to pay for Blue Cross with her savings. Drug and prescription coverage can make the difference between paying one-hundred dollars or five-hundred-to-six-hundred dollars each month for medicine.
“If I decide to retire before I'm sixty-five, I would have to pay one-hundred dollars for Blue Cross a month, which I don't have now. If I decide not to do Blue Cross, I will pay six-hundred dollars for all the medication. If I were to retire, I would have to make that choice, so my choice is that, no, we wouldn't be able to afford it.” Says Witwer.
Witwer says she will work until she is sixty-five.
“If I was on my husband's Blue Cross Plan, they would pay that additional, twenty or twenty-five dollars a month. I'm paying twenty-five dollars now regardless because I'm not covered by his Blue Cross.” Says Witwer.
Witwer says if a drug is too expensive and there isn’t a cheaper version for it, she has to pay an extra twenty-five dollars. The reason why the drug would be expensive is because there is not enough of it out there to be used. There was a previous drug Witwer was on that was cheaper than the others but because the manufacturing of that drug stopped, Witwer has to dish out the extra funds to pay for the more expensive version of the drug.
During an Alberta New Democratic Party (NDP) media advisory on April 19, the leader of Alberta`s NDP, Rachel Notley, says with each passing year the UCP makes it harder for Albertans to access health care.
“They need health care which becomes much more necessary if you can't afford the prescription drugs your doctors have told you to take to avoid getting critically ill.” Says Notley.
Notley says demands on Alberta`s health care systems increase when people can't afford the basic medications and supplies, they need to stay healthy.
Prescription drugs listed in the Alberta Drug Benefit List are covered. The co-payment is thirty per cent, reaching a maximum of twenty-five dollars.
“When people can’t afford their medication, they get more and more ill and it’s very likely they end up costing the healthcare system far more because they end up having to get more acute medical treatment.” Says Notley.
Angela Pitt, MLA for Airdrie East, says seniors in Alberta would not find themselves in a situation where they don't have a drug care plan.
“The coverage for the Seniors Drug Benefit Program cost the Alberta taxpayer five-hundred-sixty million dollars in 2018, with a growth rate close to eight per cent year-over-year.”
Pitt says the last time changes were made to the Seniors Drug Benefit Program was in 2019, and it wasn't changed for seniors, but for the dependents and spouses of seniors. Prior to the change, over eight-thousand dependents of seniors were between the ages of nineteen and fifty-four and were on the senior's drug plan.
“Any Albertan that is struggling financially for any reason has the ability to apply for assistance through various government programs, depending on what category they fall into. If they're over the age of sixty-five, they fall in the Alberta seniors drug plan, if they're under the age of sixty-five, there are programs available for people in that age category.” Says Pitt.
The government is constantly monitoring the situation of paying an out-of-pocket cost to get access to the medication seniors need to make the best plan they can for those who need it.
“It was completely unreasonable for someone who was the age of nineteen to be covered under a senior's drug plan. These sorts of things just don't make sense when you have a system that's ever-facing increasing cost pressures.” Says Pitt.
Before its reversal, the Seniors Drug Benefit Program provided coverage for many prescriptions that households need, as long as one person who lived there was over the age of sixty-five.
The changes the UCP made removed spouses and dependents from the program if they are under the age of sixty-five, including children. The plan took effect on March 1, 2020.
After reversing the Seniors Drug Benefit Program, the UCP explored some low-income options. These options for drug coverage included buying private insurance or paying for the government-sponsored non-group program administered by Blue Cross.
Another low-income option is the Alberta Adult Health Benefit where people who are pregnant, or have high ongoing prescription needs, can receive up to sixteen-thousand-five-hundred-eighty dollars for their drug needs.
The drugs covered under the Alberta Seniors Drug Benefit Program are the same as the drugs covered under the government-sponsored non-group program.
Approximately 40,126 Albertans lost their coverage in 2020, according to the Alberta Health Care Insurance Plan statistical supplement. The Alberta Health Care Insurance Plan statistical supplement does not report how many Albertans will not be enrolled in the program after 2021 who would have previously been eligible for it.
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