MEDICARE HMO Rx BENEFITS: New Study Finds Wide Variation
A study recently released by the Kaiser Family Foundation finds great variances in managed care organizations' prescription drug benefits for Medicare recipients, the New York Times reports. In an analysis of the 15% of all Medicare beneficiaries who are members of HMOs, the study found that "one in six were in a plan with no drug benefits, while one in four were in a plan with unlimited drug benefits. The rest were in the middle, with about a third in a plan with annual drug benefit limits of more than $1,000." The study is expected to lend credence to President Clinton's push for universal prescription drug benefits for all Medicare beneficiaries. The study "questions the general presumption that all beneficiaries in Medicare HMOs have good coverage for their drugs," says Tricia Neuman, director of the Medicare Policy Project at Kaiser. Chris Jennings, coordinator of health policy at the White House, adds that evidence points to an increasing number of HMOs capping drug benefits. But Susan Pisano, a spokesperson for the American Association of Health Plans, counters that limited drug benefits are necessary while the managed care industry continues its struggle "with the federal government over the adequacy of payments for Medicare beneficiaries" (Toner, 8/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.