The Medicare Drug Benefit in California: Facts and Figures
CHCF.org:
Since the implementation of the Medicare Part D drug benefit plan on January 1, 2006, an estimated 39 million beneficiaries (about 89% of the total Medicare population nationwide) have signed up for some type of prescription drug coverage.
These beneficiaries, most of whom have enrolled in Medicare Part D, have numerous plan choices that vary by premium cost, plan structure, and prescription drug coverage.
This presentation examines the key elements of Part D plan availability, enrollment, formulary coverage, and cost sharing to provide a portrait of Part D implementation in California.
It is intended to help assess the success of the Medicare prescription drug benefit, establish a baseline to evaluate the benefit over time, and identify important issues and options facing policymakers today.
About 2.8 million Medicare beneficiaries in California are enrolled in Part D; however, approximately 700,000 beneficiaries appear to have no source of drug coverage and are believed to be disproportionately low-income.
Proportionally, more beneficiaries in California have Part D coverage than in the rest of the country; however, enrollment has been very uneven among Californiaâ¬(TM)s 58 counties.
About 75% of Medicare beneficiaries in California are enrolled in plans offered by one of five commercial sponsors.
Nearly half of Medicare beneficiaries in California are enrolled in drug plans that qualified for auto-enrollment of dual-eligible beneficiaries.
In general, these plans have lower premiums and cover more drugs than the others.
Another 40% of beneficiaries enrolled in a Medicare Advantage managed care drug plan.
Low income Medicare beneficiaries also covered by Medi-Cal face much higher cost sharing under Medicare than they did under Medi-Cal.
