Medicare Monday: How Part D Extra Help works for Katie

In the past, we’ve taken a closer look at the Medicare Part D Extra Help program and how it supports patients like Diane and Mateo – two hypothetical, low-income Medicare patients over the age of 65. But how might the program support a patient who is only 31?

Katie is a hypothetical patient who has been living with end-stage renal disease and is now six months post-kidney transplant, which qualifies her for Medicare before the age of 65. The coverage she receives under the Part D Extra Help program, or the low-income subsidy, has helped her access crucial medications while avoiding costly hospitalizations.

(View Katie's full profile here)

Katie’s anti-rejection medicine, an immunosuppressant, is a key medicine in her transplant recovery and is included in Part D’s protected classes. The protected classes in Part D mean patients have access to “all or substantially all” medications within six specific classes of medicines – helping patients manage complicated diseases, like HIV, cancer, mental health, epilepsy and organ transplantation, where many treatment options are not interchangeable.

Recent proposals to remove certain classes from protected status or alter patient copays under the Extra Help program put patients at unnecessary risk by potentially increasing out-of-pocket costs and reducing adherence to needed medicines.

To learn more about the importance of protecting beneficiaries who receive Extra Help, click here.

Visit PhRMA.org/PartD to learn more about Medicare Part D.