The new prescription drug program created by the GIC, called Generics Preferred, went into effect on July 1. According to the GIC, members of the Indemnity, Plus, PPO, and OME (Medicare) plans will pay a higher cost for a Non-Preferred Brand Name drug if a generic version of that drug is available.

In practice what this means for retirees is that if they are prescribed a Non-Preferred Brand Name drug, when a generic is available, then they will have to pay the difference in actual cost of the drug out of their own pocket. For example, if the actual cost of the prescribed drug is $100 for a 30 day supply and the generic version is only $20, then the retiree must pay the $80 dollar difference.

On top of paying the difference in cost, the retiree would also pay the generic retail or mail order co-payment. Retirees should expect to pay these new fees at the point of purchase, before they are given access to their medication.

"This is a complete outrage," said an angry Association President Ralph White. "It is not enough that the GIC did away with the Medicare reimbursement, costing retirees an additional $700 a year. Now they turn around and hit our members with this.

"Many retirees are already finding it difficult to afford their insurance and the cost of their prescription co-payments. This new drug program could cost a retiree hundreds or even thousands extra each year. I would love to know how the GIC expects retirees to afford these new costs?"

Insurance officials claim that the Generics Preferred program will foster greater use of so-called generic drugs, rather than the more expensive name brands. This idea is based on the philosophy that all generics are equal to the name brand drugs.

Unfortunately, this claim is not always the case. After attempting to take a generic drug, members sometimes discover that it does not correct the problem it is designed for. In fact, many retirees try several different medications before finding the one that works best for them. This process is, of course, carried out under the supervision of one's physician.

The major flaw in the GIC's scheme is that the program does not allow for an appeal or waiver process for those retirees who must take the Non-Preferred Brand Name drug, due to a documented medical condition. In other words, even if no other drug will work, the retiree is still left having to pay the higher cost.

"Massachusetts already has a generic dispensing law on the books, whereby pharmacies must fill the prescription with a generic unless the doctor specifically states not to. As a result, the state has one of the highest generic utilization rates in the country," explains Association Legislative Liaison Shawn Duhamel. "This new policy is unnecessary and punitive against retirees, who must take the more expensive drug by no fault of their own."

Now that the GIC's policy has been implemented, a number of members have begun contacting the Association to voice their disgust. Many are enrolled in Medicare Part B and have witnessed their Part B reimbursement stripped away.

One such member is Louis Yelle, who retired as an emeritus professor of business administration at UMass Lowell in 2001. Yelle had served thirty-one years as a professor in the state college system, after having been recruited from a lucrative position in private industry.

Yelle was shocked to discover in July that the cost of his three month prescription of K-Lor had gone from $70 to $719. His wife saw the cost of one of her prescriptions rise from $70 a quarter to $221. All told, the Yelles are paying over $1,000 a quarter for their prescriptions.
"What gets me is not so much the money, but rather the whole concept behind this hideous plan. I am forced to take K-Lor because of a medical condition and none of the generics do a thing for me. I know this because I have already tried taking them," said Yelle. "To not allow for an appeal process is reprehensible.

"In terms of the costs my wife and I now face, between the Medicare money that has been taken away and this new drug policy we are paying nearly $5,000 more a year for our insurance. How are people supposed to afford this?

"The other point that has me angered is the fact that benefits are being taken away from people like me who worked a lifetime for the Commonwealth. I could have stayed in the private sector and made a bundle like my former colleagues, but I wanted to teach. All I ask for in return is for the state to live up to what they promised us."

Members, who have fallen victim to the increased insurance costs can certainly relate. With countless calls coming into the Association's Boston office from irate members, our legislative team is seeking relief from the Legislature. The Association has already filed legislation (SB 1531) requiring an appeal process be established.

"Rest assured that we are doing everything we can to address this problem. As word gets around Beacon Hill, legislators are outraged and are seeking answers," continued Duhamel. "The GIC is dead wrong and must be held accountable. Enough is enough."