is 65% drug coverage among us medicare beneficiaries enough?
TRANSCRIPT
10 INTERNATIONAL RESEARCH & OPINION
Is 65% drug coverage among US Medicare beneficiaries enough?
A significant proportion of US Medicare beneficiaries have some level of drug coverage, according to a survey conducted by US-based researchers.
The 1995 Medicare Current Beneficiary Survey* (MCBS) showed that 65% of Medicare beneficiaries living in the community have some form of outpatient prescription drug coverage. Of the beneficiaries with some form of coverage, 62% received the drug coverage from their primary supplemental plan. At this time, 3 million Medicare beneficiaries were enrolled in risk plans. However, the researchers point out that there was wide variation in the extent of protection.
Coverage high among HMO enrollees The survey also indicated that 95% of Medicare
health maintenance organisation (HMO) enrollees had drug coverage. High levels of drug coverage were also found among those Medicare beneficiaries who were also receiving Medicaid (88%), who had employer-sponsored supplemental insurance (84 %), and those who had other public coverage, such as a state-based drug plan or coverage by Veterans Affairs (78%). Only 29% of beneficiaries with individually purchased private Medigap plans had drug coverage from the Medigap plans.
For the average Medicare beneficiary living in the community, drug expenditure totalled $US600 in 1995, accounting for payments from all sources. The lowest drug expenditure was $US458lbeneficiary at Medicare risk HMOs. Out-of-pocket payments were highest for beneficiaries with individually purchased Medigap plans and lowest for those with Medicaid ($US437 vs $US 150 per beneficiary, respectively). Out-of-pocket expenses were a lot higher among Medicare beneficiaries than among other US citizens (50 vs 34% of total drug payments, respectively), note the researchers.
Beneficiaries use on average 18.5 prescriptions per year, according to the survey. Therefore, the Medicare population clearly has a need for coverage, say the researchers. * The MCBS is an ongoing panel survey of about 12 ()()() aged and disabled beneficiaries. Davis M. Poisa! J. Chulis G. Zarabozo C. Cooper B. Prescription drug coverage. utilization. and spending among Medicare beneficiaries. Health Affairs 18: 231-243. Jan-Feb 1999 .007476"
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