Navigation Links
Medicare Drug Plan 'Doughnut Hole' Could Impact Seniors' Health
Date:2/3/2009

Lack of coverage can spur cutbacks in necessary prescriptions, study finds

TUESDAY, Feb. 3 (HealthDay News) -- American seniors who reach the no-coverage "doughnut hole" in the Medicare Part D drug plan are less likely to use prescription drugs than those with an employer-based plan, a new study finds.

The finding raises concerns about health consequences and increased costs from hospitalizations and doctor visits resulting from this lack of drug coverage, say researchers at the University of Pittsburgh Graduate School of Public Health.

A change in policy that would mandate the coverage of generic drugs in the doughnut hole through a modest increase in initial prescription co-payments could help protect seniors, the team suggested.

The doughnut hole in Medicare Part D begins when a person's annual individual drug expenditures reach a certain amount, pegged at $2,250 in 2006. Coverage begins again when those expenses reach the "catastrophic" phase of coverage, which was $5,100 in 2006.

The University of Pittsburgh team compared two groups of seniors with Medicare drug coverage provided by a large Pennsylvania insurer in 2006. One group was covered through Medicare Advantage prescription drug plans (MA-PD) with either no doughnut hole coverage or generic coverage only. The other group was covered through more generous employer-sponsored plans with full coverage in the doughnut hole.

One in four (25 percent) of those enrolled in MA-PD reached the doughnut hole, the researchers reported, but only 5 percent of that group reached the catastrophic phase of coverage.

Those who lacked coverage in the doughnut hole reduced their monthly prescriptions by 14 percent once they entered the doughnut hole, compared to only 3 percent of those with generic coverage in the doughnut hole. The researchers saw no reduction in prescriptions for those with employer-based plans.

Those with diabetes were more likely to reach the doughnut hole, and reach it sooner, than those with hypertension. Seniors with more than one chronic illness were also much more likely than others to reach the doughnut hole -- 34 percent of those with both hypertension and diabetes reached it, as did 61 percent of those with hypertension, high cholesterol, congestive heart failure and diabetes.

The study was published online Tuesday in the journal Health Affairs.

"Our findings raise concerns about whether people with chronic illnesses who lack doughnut hole coverage are able to effectively manage their conditions. Without needed prescriptions, we could potentially see an increase in hospital and physician costs," lead author Yuting Zhang, an assistant professor of health economics, said in a university news release.

More information

The U.S. Centers for Medicare and Medicaid Services offers tips for reducing costs during the coverage gap.



-- Robert Preidt



SOURCE: University of Pittsburgh Schools of the Health Sciences, news release, Feb. 3, 2009


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. GAO Report Confirms: Medicare Underpays for Anesthesia Services; Nurse Anesthetists Assure Seniors Access to Safe Anesthesia Care
2. Texas Supreme Court Rules Against Medicare HMOs in Hospital Reimbursement Fight
3. Owner and Operator of Florida Durable Medical Equipment Company Convicted of Medicare Fraud
4. Just Completed Studies Reveal Impact of New Medicare Reimbursement Regulations
5. AHCA: Rescinding $2.7 Billion Medicare Cuts Top Issue for Fall Legislative Agenda
6. University of Texas Study Details Lengthy Payment Delays for Medicare Part D Prescription Drug Claims, Confirming Need for Legislative Fix
7. Medicare Spending Caps Cause Seniors to Stop Meds
8. Medicare Prescription Drug Benefit, Nonprofit Hospitals, Ambulatory Surgery Centers, Statistical Methods, and Pay-For-Performance Highlighted In the Latest INQUIRY Journal
9. Medicare Every Diabetic Counts Project Gears Up for Kick-Off
10. Medicare Cuts to Physicians Will Harm Washington Seniors
11. More than 10,000 Medicare Patients in Montana Could Be Hit by Proposed Cuts to Home Oxygen Therapy; Access to Power Wheelchairs Would Also Decrease
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Medicare Drug Plan 'Doughnut Hole' Could Impact Seniors' Health
(Date:5/23/2017)... ... 23, 2017 , ... Drs. Allen Huang and Jeffrey Wang, ... Las Vegas, NV, and the importance of treating it immediately. They are now ... for peri-implantitis, with or without a referral. As experienced periodontists and implant specialists, ...
(Date:5/23/2017)... ... May 23, 2017 , ... Diagnotes, an Indianapolis-based digital ... feature on its secure clinical communication platform. The platform allows clinicians to easily ... the type and urgency of a situation. , “We know from our ...
(Date:5/23/2017)... ... May 23, 2017 , ... Orbita’s Nathan Treloar will discuss the role of ... Francisco. Titled Connected Health and IoT: Technology Innovators and Disruption , the workshop ... Associates, a market research and consulting firm specializing in emerging consumer technology products and ...
(Date:5/23/2017)... ... 23, 2017 , ... New patients looking for an alternative ... or without a referral, from the multi-specialty Dr. Smile practice. Dr. Esther Feldman ... in providing patients with the custom, convenient and long-lasting orthodontic treatment that helps ...
(Date:5/23/2017)... Mt. Horeb, WI (PRWEB) , ... May 23, 2017 , ... ... now invited to call Dr. Angela Cotey’s practice to schedule an appointment, with or ... dentistry services, and frequently offers pulpotomy treatments to pediatric patients as a healthy alternative ...
Breaking Medicine News(10 mins):
(Date:5/4/2017)... Fix Inc. (" Fortuna "), a private, clinical-stage biotech ... need for embryonic and fetal stem cells by using direct ... Fortuna announced today the launch of its Scientific ... PhD; Father Kevin FitzGerald , S.J., PhD; Col. (R) ... Giordano , PhD. "We are excited and honored ...
(Date:5/4/2017)... , May 4, 2017  DarioHealth Corp. (NASDAQ: ... health and big data solutions, today announced that it ... Company, and STI Technologies Limited to lower diabetes healthcare ... Through STI,s innoviCares card, which is available throughout all ... DarioHealth customers will be eligible for additional savings when ...
(Date:5/3/2017)... ROCKVILLE, Md. , May 3, 2017 /PRNewswire/ ... revenue growth of nine percent next year and ... solid organ and hematopoietic stem cell (HSCT) or ... and donor. Molecular testing technologies are well-suited for this ... healthcare-only market research publisher Kalorama Information. The various ...
Breaking Medicine Technology: