Medicare News
| For Immediate Release: | Contact: |
| Monday, March 12, 2001 | CMS Office of Public Affairs 202-690-6145 |
For questions about Medicare please call 1-800-MEDICARE or visit www.medicare.gov. |
|
STUDY SHOWS DIFFERENCES WIDEN BETWEEN MEDICARE BENEFICIARIES WITH AND WITHOUT DRUG COVERAGE
Medicare beneficiaries who had prescription drug coverage in 1998 filled more prescriptions and paid considerably more for them than in 1997, according to a study by the Health Care Financing Administration (HCFA), which administers the Medicare program. Out-of-pocket expenses for prescription drugs for beneficiaries with coverage were lower than for beneficiaries without coverage.
The study, "Growing Differences Between Medicare Beneficiaries With and Without Drug Coverage," by John A. Poisal and Lauren Murray of HCFA, is based on data from the 1998 Medicare Current Beneficiary Survey, the most current data available. The study is published in the March/April issue of Health Affairs.
The authors found that Medicare beneficiaries without drug coverage filled 2.4 percent fewer prescriptions in 1998 than in 1997, but paid out-of-pocket costs of about $550 both years. Those with coverage got 9 percent more drugs than the year before, paid 18 percent more for them, yet they paid $453 less in total out-of-pocket costs in 1998 than the non-covered group. On average, beneficiaries without coverage spent $33 per prescription while beneficiaries with coverage spent $13.
The rate of beneficiaries who had prescription drug coverage at any point during the year was 73 percent, the same as in 1997, the first year since 1992 that the coverage rate did not increase. But the difference in the number of prescriptions filled by beneficiaries with drug coverage, compared to those without, grew from 5 prescriptions to 8 prescriptions, or an average of 24.4 prescriptions for beneficiaries with coverage compared to 16.7 prescriptions for beneficiaries without coverage.
Since Medicare does not directly provide an outpatient drug benefit, most enrollees get prescription drug coverage from a private supplemental insurance plan, such as a Medigap policy, an employer-sponsored retirement plan or Medicare+Choice organization. Some beneficiaries are covered under a publicly funded plan, like Medicaid or a plan funded by the Department of Veterans Affairs. The authors found that from 1997 to 1998, out-of-pocket spending grew faster than third party payments for beneficiaries with drug coverage and those beneficiaries are paying a higher percentage of their total drug cost, rising from 31 percent to 33 percent.
Information about free or discounted prescription drug options for Medicare beneficiaries with low incomes is available on HCFA's Web site: www.medicare.gov. The Prescription Drug Assistance Program directory contains a comprehensive list of all drug assistance programs, nationwide, as well as contact information for applications. Updated monthly, the directory includes information on state assistance programs, disease specific programs, and pharmacy programs. The Web site also provides Medicare Health Care Compare, a databank which includes information about Medigap and Medicare+Choice plan benefits and premiums, by zip code, that can help consumers make informed health care choices.
