Rx DRUGS: Seniors Lacking Coverage on the Rise

      The number of California seniors lacking prescription drug coverage rose substantially between 1998 and 1999, the Los Angeles Times reports. A New England Medical Center study, which is part of a comparison research project reviewing care received by seniors in managed care plans versus traditional fee-for-service Medicare plans, discovered that among 3,000 California seniors, the percentage of those without insurance coverage for prescription medication increased to 34% in 1999, up from 25% in 1998. Similar increases were reflected in 11 of the 13 states reviewed in the study; yet the numbers were "particularly striking" in California where 30% of the elderly are enrolled in HMOs compared to 16% nationwide. Since Medicare does not offer a prescription drug benefit, seniors must instead purchase a supplemental insurance policy, enroll in an HMO with a drug plan or obtain it through participating former employers. In recent years, many Medicare managed care plans have capped annual prescription drug payouts, while others have dropped prescription drug coverage altogether. Study co-author and New England Medical Center health policy analyst Dana Safran said, "For the HMOs, prescription drug coverage is an optional benefit -- it's not something they have to provide." Seniors without drug coverage typically pay "significantly higher prices" for drugs than do those with insurance, primarily because insurers purchase drugs in bulk. The study also found that 9% of California's elderly had skipped taking medication at some point due to the high cost. The study was funded by HHS's Agency on Health Care Quality and Research and by the National Institute on Aging (Rubin, 8/17).