Low-Income Medicare Beneficiaries and Their Experiences with the Part D Prescription Drug Benefit

Author(s):  
Noemi V. Rudolph ◽  
Melissa A. Montgomery
2005 ◽  
Vol 21 (2) ◽  
pp. 63-68 ◽  
Author(s):  
Mary F Powers

Objective: To review recent changes in Medicare affecting the practice of pharmacy. Data Sources: Articles were identified through searches of MEDLINE (2003–March 2004), LEXISNEXIS ACADEMIC (2003–March 2004), and LEXISNEXIS CONGRESSIONAL databases (2003–March 2004), using the key words Medicare, pharmacist, pharmacy, and drug costs. Additional references were located through review of the bibliographies of the articles cited and through searches of the Web sites for Medicare, Social Security, and the American Pharmacists Association. Study Selection and Data Extraction: Reports about Medicare and Medicare Part D were selected. Articles describing the history of Medicare and changes that impact pharmacy were included. Data Synthesis: The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MPDIMA) provides an optional prescription drug benefit for Medicare beneficiaries in 2006 as Medicare Part D. Before its full implementation, eligible Medicare beneficiaries may qualify for a temporary Medicare-approved Drug Discount Card. The prescription drug benefits will be administered by private entities. Other provisions of the MPDIMA affect pharmacy, including a provision for medication therapy management services to ensure that the covered Part D drugs are appropriately used. This will be the first time that Medicare provides for payment of pharmacist-administered patient care services. Conclusions: Recent changes in Medicare provide Medicare beneficiaries with optional coverage for prescription drugs. Full implementation of the Medicare prescription drug benefit will occur in 2006, with an interim Drug Discount Card available through December 2005.


2008 ◽  
Vol 13 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Moupali Das-Douglas ◽  
Elise D. Riley ◽  
Kathleen Ragland ◽  
David Guzman ◽  
Richard Clark ◽  
...  

Author(s):  
Katherine A. Desmond ◽  
Thomas H. Rice ◽  
Arleen A. Leibowitz

This article examines whether California Medicare beneficiaries with HIV/AIDS choose Part D prescription drug plans that minimize their expenses. Among beneficiaries without low-income supplementation, we estimate the excess cost, and the insurance policy and beneficiary characteristics responsible, when the lowest cost plan is not chosen. We use a cost calculator developed for this study, and 2010 drug use data on 1453 California Medicare beneficiaries with HIV who were taking antiretroviral medications. Excess spending is defined as the difference between projected total spending (premium and cost sharing) for the beneficiary’s current drug regimen in own plan vs spending for the lowest cost alternative plan. Regression analyses related this excess spending to individual and plan characteristics. We find that beneficiaries pay more for Medicare Part D plans with gap coverage and no deductible. Higher premiums for more extensive coverage exceeded savings in deductible and copayment/coinsurance costs. We conclude that many beneficiaries pay for plan features whose costs exceed their benefits.


2010 ◽  
Vol 5 (4) ◽  
pp. 437-457 ◽  
Author(s):  
Thomas Rice ◽  
Yaniv Hanoch ◽  
Janet Cummings

AbstractQuestions about the design of the new US Medicare prescription drug benefit were raised even before its passage, where one of the most heated issues has been the number of plans offered to beneficiaries. Whether beneficiaries believe that there should be extensive or limited choice is still an open question. To study this issue, we analyzed data from the Kaiser Family Foundation/Harvard School of Public Health Survey, which included 718 individuals aged 65 years and above. The survey asked these older adults (i) whether they prefer having dozens of plans or for Medicare to offer a restricted number of plans and (ii) whether they think there are too many, too few or the right amount of plans. Our findings show that the majority of beneficiaries (69%) preferred that Medicare offer a limited number of options while only 29% wanted to see dozens of plans on the market. We also examine the effect of education level, income, political affiliation, race and health status on the desire for more or fewer plans. One surprising finding is that seniors with higher education appear to prefer fewer, not more, plan choices. Overall, our results question the merit of offering so many prescription drugs plan choices to Medicare beneficiaries.


Author(s):  
Richard R. Cline ◽  
David A. Mott

Several proposals for adding a prescription drug benefit to the Medicare program rely on consumer choice and market forces to promote efficiency. However, little information exists regarding: 1) the extent of price sensitivity for such plans among Medicare beneficiaries, or 2) the extent to which drug-only insurance plans using various cost-control mechanisms might experience adverse selection. Using data from a survey of elderly Wisconsin residents regarding their likely choices from a menu of hypothetical drug plans, we show that respondents are likely to be price sensitive with respect to both premiums and out-of-pocket costs but that selection problems may arise in these markets. Outside intervention may be necessary to ensure the feasibility of a market-based approach to a Medicare drug benefit.


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