Seniors Remain Uncertain About New Medicare Prescription Drug Benefit, Survey Finds

With less than one week before enrollment in the new Medicare drug benefit is scheduled to begin, many seniors remain uncertain about the new coverage and undecided about whether they will enroll, according to a survey released Thursday by the Kaiser Family Foundation and the Harvard School of Public Health, the Akron Beacon Journal reports (Powell, Akron Beacon Journal, 11/11). The survey, conducted Oct. 13 to Oct. 31, includes responses from 802 seniors. It has a margin of error of plus-or-minus 3.5 percentage points (CQ HealthBeat, 11/10).

According to the survey, 61% of seniors say they understand the new benefit "not too well" or "not at all," while 35% say they understand it "very" or "somewhat" well (Washington Post, 11/11).

Seniors' knowledge of important elements of the new benefit varied, with the majority correctly stating that most seniors will need to sign up for coverage. However, more than four in 10 seniors say they do not know if there are financial penalties for late enrollment or report incorrectly that there are no penalties (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10).

Forty-nine percent of seniors say they do not think the drug benefit will help them personally, compared with 39% who say it will, the survey indicates (Alonso-Zaldivar, Los Angeles Times, 11/11).

Forty-three percent of seniors say they have not yet decided whether to sign up for the benefit, while 37% say they will not enroll and 20% say they will, according to the survey (Appleby, USA Today, 11/11).

Those without existing drug coverage are more likely to say they will enroll than those with existing drug coverage, the survey indicates (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10).

Meanwhile, only 5% of seniors are aware that they will have more than 20 different plan options from which to choose, the survey shows. When informed that the government has announced that most people will have at least 40 drug plans to choose from, nearly three in four seniors say having many available plans makes it "confusing and difficult to pick the best plan" (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10).

When asked about their overall views of the drug benefit, 37% of seniors say they have an unfavorable view of it, compared with 31% who view it favorably (Freking, AP/Rochester Democrat and Chronicle, 11/10). Thirty-one percent of seniors say they do not know how they view the drug benefit (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10). Seniors who say they understand the benefit are more likely to report a favorable view of it, according to the survey.

In addition, 77% say they believe the drug benefit will help low-income seniors (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10). However, 50% of those most likely to be eligible for financial help under the benefit are unaware that they might qualify, according to the survey (Los Angeles Times, 11/11).

Among those who now plan to enroll, 35% say the most important factor in determining which plan they choose will be how much they pay out of pocket for prescriptions, compared with 19% who cite "which drugs the plans cover," and 16% who cite "how much the plan charges for monthly premiums." Seniors most often say they "very likely" will turn to their personal doctor or the Medicare program itself for help making decisions about the drug benefit, while fewer say they will seek help from their pharmacist, the Social Security Administration, friends and family members, or a seniors' group or community organization (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10).

In addition, more than half of seniors say their pharmacists and doctors are likely to help them choose a drug plan (Reuters/Newark Star-Ledger, 11/11). Most seniors expect their providers to be knowledgeable about their options (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10).

"We're less than a week away from enrollment, and it's not really clear whether most seniors will jump in the pool or sit on the sidelines," Kaiser Family Foundation President and CEO Drew Altman said, adding, "If it was completed next week, most wouldn't enroll" (Krasner, Boston Globe, 11/11).

Mollyann Brodie, a Foundation vice president and director of public opinion and media research, said, "About three in four seniors expect to lean heavily on their doctors and pharmacists to guide them through their options, but those expectations may not be realistic" (Moos, Dallas Morning News, 11/11).

Robert Blendon, a professor of health policy at Harvard, said, "If people had to make a selection today, a large number would not do so. Some of them are going to say, 'This is just too confusing for me. I'm just not going to do anything'" (Akron Beacon Journal, 11/11).

"It's going to take time for seniors to become comfortable with the choices they have," HHS Secretary Mike Leavitt said, adding, "Enrollment may start out slowly. But we're confident that over time seniors are going to like the benefit" (Pugh, Knight Ridder/Contra Costa Times, 11/11). Leavitt noted that the "feedback [CMS is] hearing on the road has been extremely positive" (CQ HealthBeat, 11/10).

CMS Administrator Mark McClellan said, "When you look at the people who say they don't plan to enroll, it's mainly because they already have coverage." He also said the public's view of the new drug benefit "depends a little bit upon which survey you see," adding, "I can get five other numbers from other places that show a lot of interest in enrolling among people who don't have coverage now" (AP/Rochester Democrat and Chronicle, 11/10).

CMS spokesperson Roseanne Pawelec said, "Recent surveys done by CMS and other groups show that awareness of the drug coverage has increased dramatically, more people are talking about the drug coverage with someone they know, and there is strong interest in enrollment, especially among Hispanic and African Americans" (Boston Globe, 11/11).

According to the Beacon Journal, CMS officials highlighted an online survey of 290 seniors published on Thursday by the Wall Street Journal Online and Harris Interactive that found about half of seniors say they likely will enroll in the Medicare drug benefit (Akron Beacon Journal, 11/11).

NPR's "Morning Edition" on Friday reported on CMS' launch on Nov. 7 of its Internet tool that allows beneficiaries to compare prescription drug plans available under the new Medicare drug benefit and a report by the HHS Office of Inspector General finding that millions of seniors and disabled people likely will need help enrolling in the benefit. The segment includes comments from Deane Beebe, director of communications at the Medicare Rights Center; Blendon; Mary Agnes Laureno, director of CMS' Beneficiary Information Services Group; and McClellan (Rovner, "Morning Edition," NPR, 11/11). The complete segment is available online in RealPlayer.