And while low-income seniors may qualify for subsidies to help pay the Part D premium and cost-sharing, more than 2 million elderly and disabled people are not getting those subsidies, she found.
Meanwhile, premiums and cost-sharing are on the rise, suggesting that seniors may not be in the best plan for their particular needs. Between 2006 and 2009, the weighted average monthly premium rose 35 percent, with the steepest increases among some of the more popular plans.
Thomas Rice, a professor in the department of health services at the University of California, Los Angeles, School of Public Health, says more needs to be done to help Medicare beneficiaries make better choices.
"People are not choosing the plan that's cheapest for them," said Rice, who noted that many older Americans have difficulty navigating the Medicare Web site to compare benefits and costs. Seniors focus too much on the premium instead of the total cost of coverage, and very few switch plans from year to year. Rice guesses that plan sponsors know this and "try to make sure their premiums look pretty cheap."
Lipschutz's best advice for seniors: Contact your State Health Insurance Assistance Program for help walking though your options. "Do your homework each and every year," he said. "It's not a one-time deal."
Compare Part D plans at Medicare.gov.
SOURCES: Tricia Neuman, Sc.D., vice president and director, Medicare Policy Project, Henry J. Kaiser Family Foundation, Washington, D.C.; David Lipschutz, J.D., staff attorney, California Health Advocates, Los Angeles; Thomas Rice, Ph.D., professor, department of health services, University of California, Los Angeles, School of Public Health; July 23, 2009, New England Journal of Medicine
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