By Mary Agnes Carey, CQ HealthBeat Associate Editor
September 14, 2006 -- Survey findings released Thursday by a group focused on educating Medicare beneficiaries about the program's prescription drug benefit highlighted successes and potential trouble spots ahead as both the government and seniors gear up for the 2007 enrollment season.
The poll, released by Medicare Rx Education Network, found that four out of five seniors enrolled in a stand-alone or Medicare Advantage prescription drug plan were satisfied with their coverage and 73 percent said the plans cover the medications they need. Nearly a third said they no longer need to skip or reduce their medications.
But a quarter of those surveyed said the Medicare drug program had not helped them reduce drug costs and 29 percent expressed frustration with the program. Nearly half of those enrolled in drug coverage were unaware of the fact that some plans have a gap—or "doughnut hole"—in coverage that requires beneficiaries to pay all of their drug costs until catastrophic coverage kicks in. Eight in 10 of those surveyed said they were unaware they could sign up for a plan that covered that gap.
At a news conference to announce the results, Centers for Medicare and Medicaid Services Administrator Mark B. McClellan said some respondents who said they are not saving money with the drug benefit are individuals who may not have drug costs now but have purchased a plan as insurance against potentially higher drug bills in the years to come. "It's a good way to protect themselves in the future," McClellan said. "What they get is peace of mind."
In addition, McClellan said that "dual eligibles," beneficiaries who qualify for both Medicare and Medicaid but now receive their drug coverage in the Medicare drug benefit, may not be saving on their drug costs but are getting access to drugs. "We're watching that population very closely," he said.
Former Sen. John B. Breaux, D-La. (1987–2005), who helped write the Medicare drug bill and is honorary chairman of the Medicare Rx Education Network, said estimates that just 8 percent of Medicare beneficiaries were projected to fall into the "doughnut hole" were far fewer than previously thought, and that overall the Medicare drug program was being received favorably by beneficiaries.
"Anytime you get anywhere near 80 percent approval rating for a government program you've hit a home run," Breaux said. He added that some of the survey's findings show that beneficiaries need more information about the types of coverage available to them.
"Our job, of course, is never complete until 100 percent are satisfied," he said. "Giving people more choices makes it more complicated."
Medicare beneficiaries who plan to sign up for the benefit or switch plans if they are already enrolled will have six weeks, between Nov. 15 and Dec. 31, to take that step. CMS, however, is encouraging beneficiaries to sign up before Dec. 8 to help smooth any potential problems with enrollment or delivery of benefits.
A coalition of 41 advocacy organizations asked Senate and House leaders Wednesday to pass legislation before adjournment that would waive the late enrollment penalty for beneficiaries. The penalty, which would be 7 percent for beneficiaries who did not enroll by the May 15 deadline, will increase over time, the groups wrote. They also said it is harsher than the late enrollment penalty beneficiaries face for Medicare Part B, which does not apply for the first 12 months after the initial enrollment period.
Organizations signing on to the letter include the National Council on Aging, the Medicare Rights Center, and Families USA.