Posting date: April 19, 2005

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Health Affairs, 10.1377/hlthaff.w5.152
Copyright © 2005 by Project HOPE

Web Exclusives

Prescription Drug Coverage And Seniors: Findings From A 2003 National Survey

¹ Dana Safran directs the Health Institute at Tufts-New England Medical Center in Boston.
² Patricia Neuman is vice president and director of the Medicare Policy Project, Henry J. Kaiser Family Foundation (KFF) in Washington, D.C.
³ Cathy Schoen is vice president for health policy, research, and evaluation at the Commonwealth Fund in New York City.
⁴ Michelle Kitchman is a senior policy analyst at the KFF.
⁵ Ira Wilson is an associate professor of medicine at Tufts-New England Medical Center and the Tufts University School of Medicine.
⁶ Barbara Cooper is senior program director; Medicare's Future, at Commonwealth.
⁷ Angela Li is a research associate at the Health Institute.
⁸ Hong Chang is a statistician at the Health Institute.
⁹ William Rogers is a senior scientist at the Health Institute.

^*Corresponding author.

Abstract

Beginning in 2006 the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) will offer pharmacy benefits to forty-two million Medicare beneficiaries nationwide. In a 2003 national survey of Medicare beneficiaries age sixty-five and older, more than one-quarter reported no prescription coverage, and nearly half of low-income seniors in some states lacked coverage. Wide coverage differences among states highlight implementation challenges and the need for tailored enrollment strategies. Evidence of Medicaid's highly effective coverage delineates the importance of assuring this group's continued protection under Part D plans. Reports of complex drug regimens, multiple prescribing physicians and pharmacies, nonadherence, and reimportation demonstrate the challenges of integrating seniors' prescription care. We discuss MMA's potential to improve quality and the need to monitor performance.

Key Words: Business Of Health, Consumer Issues, Elderly, Health Reform, Insurance Coverage, Medicare, Pharmaceuticals, Health Spending

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