Current debates center on the appropriate type of drug coverage for U.S. senior citizens. In this study, data derive from 10,000 Medicare beneficiaries in 13 states with high Managed Medicare (MM) enrollment. The sample excluded seniors enrolled in their current Managed Medicare HMO or in Conventional Medicare (CM) for less than one year. Differences in prescription drug coverage were assessed between CM and MM. The amount of money patients pay out of pocket every month for medications was measured. In both systems, nearly 40% of patients lack prescription coverage. In CM, the percentage of those spending more than $100 a month on drugs was significantly higher for those without drug coverage (33.6%) than for those with it (8.5%) (p<0.05). Corresponding figures in MM were 14.3% and 5.8% (p<0.05). In both systems, nearly 10% of patients with drug coverage spend more than $100 a month on medications, suggesting a failure of the benefit to cover needed medications. Across all income categories, a substantial proportion of people spend over one-tenth of their income on prescriptions. These results signal that although MM seems to be reducing the amount the elderly pay for prescriptions, seniors are still paying high out of pocket costs regardless of system (CM or MM). With so many seniors spending a large percent of their income on medications, there remains reason for concern that seniors are having to choose between affording their medications and other staple items.
Learning Objectives:
Keywords: Managed Care, Medicare
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.