Despite substantial increases in Medicare prescription drug coverage, a significant number of seniors still face unaffordable out-of-pocket expenses, a new study shows.
The study released Aug. 21 and conducted by the Kaiser Family Foundation, Commonwealth Fund and Tufts-New England Medical Center showed that seniors who relied on Medicare Part D did not fare as well as those who relied on employer-based coverage or coverage provided by the Veterans Affairs.
The study was based on a random-sample survey in fall 2006 of more than 16,000 seniors and provides a comprehensive look at seniors' out-of-pocket spending. More than one-third of seniors in the study said they spent at least $100 per month for their prescriptions.
"The Medicare drug law achieved its primary goal of providing drug coverage to most seniors who previously lacked it," said Kaiser President and CEO Drew E. Altman. "But the survey found a significant number of seniors in Part D plans paying sizable amounts out-of-pocket for their medications and delaying or not filling their prescriptions for cost reasons."
Commonwealth Fund President Karen Davis said it is important that coverage be adequate to ensure financial protection and access to prescription drugs. "We still have a lot of work to do to make sure that Medicare beneficiaries - particularly those who are most vulnerable because of low incomes or chronic illness - can get the drugs they need and are not subject to burdensome out-of-pocket costs."
Other key findings from the study included:
- In 2006, 8 percent of seniors lacked drug coverage - compared to about 33 percent of seniors without drug coverage in 2005, prior to Medicare Part D implementation
- Those who lacked drug coverage came mainly from two contrasting groups: vulnerable, hard-to-reach populations or seniors in good health
- Overall, half of all seniors received benefits through a new Medicare Part D drug plan - either a Medicare Advantage or a stand-alone plan
- Nearly one-third (31 percent) of seniors received drug coverage through an employer plan
- One in four seniors in a Part D plan (26 percent) reported spending at least $100 per month.
"Low-income subsidies really make a difference for those seniors who receive them, but there are still millions of low-income seniors who are eligible for this help but not getting it," said study lead author Tricia Neuman, Sc.D., a Kaiser vice president and director of the Foundation's Medicare Policy Project. "Our study confirms the importance of doing more to get additional assistance to low-income seniors."
The study also found that seniors receiving both Medicare and Medicaid faced some of the biggest challenges in the transition to Medicare Part D.