Chief Patron: Jones S.C.
Medicare Part D Gap Coverage for HIV-Positive Persons

Item 305 #1h

Language
Page 272, line 23, strike "$14,222,481" and insert "$14,722,481".
Page 272, line 23, strike "$14,222,481" and insert "$14,722,481".
Page 273, after line 7, insert:
"C.  Out of this appropriation, $500,000 the first year and $500,000 the second year shall be provided for insurance premium payments for individuals participating in the insurance premium program for HIV-positive individuals and individuals participating in the Virginia AIDS Drug Assistance Program with incomes between 135 percent and 200 percent of the federal poverty income guidelines and who are Medicare Part D beneficiaries.  These insurance premium payments shall be used to provide gap insurance to cover annual prescription drug costs that are not covered through the Medicare Part D prescription drug program, including coinsurance and costs that exceed $2,850 but are less than $5,100, the range of costs for which the Medicare Part D program provides no coverage."

Explanation
(This amendment expands the premium assistance program for HIV-positive individuals who are Medicare Part D beneficiaries to cover the price of gap insurance for prescription drug costs that are not covered by the Medicare Part D program, including coinsurance and coverage for prescription drug expenses in the "donut hole." The Medicare Part D program does not cover drug costs between $2,850 and $5,100 for some beneficiaries with incomes above 150 percent of the federal poverty level (referred to as the "donut hole"). Further, the Medicare Part D program requires individuals with incomes between 135 percent and 150 percent of the federal poverty income guidelines to pay 15 percent of their annual prescription drug expenses up to $2,850. For persons living with HIV/AIDS, this could cost from $200 to $300 per month. This program would help to ensure that medications are continuously available without interruption for persons living with HIV/AIDS who require medication to maintain health and prevent more costly illnesses.)