Feature Story

September 5, 2007

Study Finds Medicare's Drug Benefit Substantially Increased Coverage Among Seniors, But Some Continue to Be Vulnerable to High Costs

From The Commonwealth Fund:

The share of seniors without drug coverage dropped significantly under Medicare's new drug benefit, according to a Health Affairs Web Exclusive article based on a Kaiser Family Foundation, Commonwealth Fund, and Tufts-New England Medical Center survey of more than 16,000 seniors.

Seniors with drug coverage from any source were less likely to face high monthly drug costs or to skip prescribed medications due to cost than seniors who remained without drug coverage.

However, seniors who enrolled in a Medicare Part D plan did not fare as well as those who relied on other sources of drug coverage, such as employer-sponsored coverage or benefits from the Department of Veterans Affairs (VA).

Conducted in fall 2006 by the Kaiser Family Foundation, the Commonwealth Fund and the Tufts-New England Medical Center, the survey provides a comprehensive look at seniors' out-of-pocket spending and cost-related experiences, broken out by type of drug coverage, with a more in-depth look at the experiences of seniors with low incomes.

As Congress considers potential changes to the drug benefit's low-income subsidy provisions, the new study also highlights the significant financial protections that the subsidies provided to those who received them.

But among low-income seniors not receiving those subsidies, nearly one in three reported that they spent at least $100 per month for their prescriptions.

"In addition to covering more seniors, it's important that coverage be adequate to ensure financial protection and access to prescription drugs," said Commonwealth Fund President Karen Davis.

Part D enrollees had slightly lower rates of cost-related skipping than seniors without any drug coverage (23%), and substantially higher rates than seniors getting prescriptions from an employer plan (8%) or the VA (12%).

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