Making Medicare Part D Work Better for the Most Vulnerable

eAlert 8fbcbbe9-8e7c-4585-84a2-066c787a879b

<p>Health insurance coverage for Medicare beneficiaries has been broadened with the addition of the Medicare Part D prescription drug benefit. But for some beneficiaries--particularly those transitioning from Medicaid to Medicare prescription coverage--the program can be confusing and even disruptive, sometimes causing delays in getting needed medications.<Br><Br>In the Commonwealth Fund issue brief, <a href="/publications/issue-briefs/2008/may/medicare-part-d--how-do-vulnerable-beneficiaries-fare
">Medicare Part D: How Do Vulnerable Beneficiaries Fare?,</a> Georgetown University's Laura Summer and her colleagues describe the challenges facing a number of Part D enrollees, based on a survey of counselors, attorneys, program managers, health professionals, and others who have direct knowledge of beneficiaries' experiences. At the heart of many beneficiaries' difficulties is the shortage of accurate, easy-to-use information about private drug plan options and procedures for navigating the plans.<br><Br>The authors discuss steps that could make Part D work better for the most vulnerable, including an electronic information system that would enable administrators to exchange “real time” information about low-income beneficiaries who are not assigned to a plan, are assigned to more than one plan, or are charged premiums or wrong copayments. Other steps include expanding point-of-service assistance, simplifying enrollment for the low-income subsidy, and providing more one-on-one counseling. <bR><br>In a companion issue brief, <a href="/publications/issue-briefs/2008/may/medicare-part-d--state-and-local-efforts-to-assist-vulnerable-beneficiaries
">Medicare Part D: State and Local Efforts to Assist Vulnerable Beneficiaries,</a> Summer and co-authors describe policies and practices that states have adopted to help low-income beneficiaries obtain and use the Part D benefit. State approaches include building coalitions among agencies, advocacy groups, and community organizations; providing assistance tailored to culturally and linguistically diverse populations; promoting enrollment in the low-income subsidy; and filling gaps in Part D coverage.<BR><br>The many examples highlighted in the brief should be of interest to program officials, health plans, providers, and advocates across the country as they seek to improve the accessibility and operations of a valuable Medicare benefit.</p>