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Medicare Drug Plan Still Needs Work
Date:7/22/2009

care's hospital and medical insurance programs, Part D benefits are offered through private insurers and drug plans that contract with the government. Often seniors must choose among dozens of plans in a region.

Enrollment in Part D began in November 2005. By the end of the first enrollment period, about 90 percent of all Medicare beneficiaries had drug coverage, according to the report. That's up from 66 percent in 2004.

Today, 59 percent of Medicare's 45.2 million beneficiaries are enrolled in Part D through a standalone prescription drug plan or a "Medicare Advantage" (HMO) drug plan. Thirty-one percent have retiree drug coverage or some other type of drug coverage. That leaves some 4.5 million without any coverage at all, the researchers report.

"People on Medicare who are still without drug coverage include beneficiaries who are relatively healthy and take few drugs who may not think they need this type of insurance," Neuman explained. Others who lack coverage "would likely benefit from having Part D coverage, but for one reason or another are unaware that they need to sign up to get it or are stymied by the process."

A recent University of Pittsburgh study, also published in the New England Journal of Medicine, found that seniors' spending on drugs increased after enrolling in Part D, while spending on medical costs declined. Researchers said that suggests people are getting better control of their medical conditions.

Neuman's paper highlights several concerns with the program, one being the infamous gap in drug coverage known as the "doughnut hole." Once seniors reach an initial coverage limit, they are responsible for any additional drug costs incurred up to a "catastrophic" limit, at which point coverage kicks in again.

Studies show that seniors who hit the coverage gap start shirking on their medication regimens, posing serious risks for people with chronic conditions, Neuman observed.'/>"/>

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