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Reform Starts Now: More Choice For Medicare’s Low-Income Rx Beneficiaries

October 18th, 2010

An oft-heard criticism of the new health care law is that its major provisions do not kick in until 2014, leaving little immediate benefit for most Americans, especially those struggling in this economy. However, the reality is that the Affordable Care Act is already helping millions of low-income seniors who have had tenuous coverage for the prescription drugs they need.

New analysis from Avalere Health finds that because of the Centers for Medicare and Medicaid’s (CMS) implementation of policy improvements in the Affordable Care Act, the Part D market for low-income beneficiaries will improve significantly in 2011.

In fact, the analysis shows that the number of plan options available for low-income beneficiaries will increase for the first time since the program began – rising by eight percent in 2011. These plans are available at no premium cost to the approximately 9 million Medicare beneficiaries who are enrolled in stand-alone prescription drug plans and who receive help through the low-income subsidy program.

In 2011, 332 prescription drug plans will offer $0 premium coverage to beneficiaries receiving the low-income subsidy. Low-income beneficiaries in most states will be able to choose from between nine and 12 plans that offer coverage with $0 premium. For 2011, all states will have at least four $0 premium plans.

Avoiding care disruptions for the most vulnerable. Because of these changes, the number of low-income beneficiaries who must be reassigned to a different plan in 2011 has decreased by 57 percent. That means both less disruption and more choice – win-win.

In past years, reductions in drug plan availability for low-income people caused confusion among millions of seniors – along with a fair dose of anger and fear. And despite CMS and health plan efforts to assure continuity of care, we don’t really know what happens to low-income beneficiaries when their care is interrupted. Low-income older Americans are one of the most vulnerable segments of our population.

For America’s low-income seniors enrolled in Part D, this will provide more consistent health and drug coverage. It’s a remarkable turn in the right direction, and it begins now.

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1 Response to “Reform Starts Now: More Choice For Medicare’s Low-Income Rx Beneficiaries”

  1. kgusglobalmedical Says:

    I think we can assume that when care is interrupted for low-income beneficiaries, more costs will accumulate for Medicare as a result of otherwise preventable hospital visits. Or at the very least, that the prescribed care is no longer adhered to causing greater medical risk.

    In addition to helping with continuity of care, as discussed in this article, the Affordable Care Act is helping to make important improvements in the Medicare prescription drug program, like helping to eliminate the “donut hole” gap in coverage when prescription costs reach $2,830 to $6,440 in a given year. This affects millions of elderly and disabled plan participants every year. I just can’t believe opponents of this act are ready to eliminate this extra help for this growing segment of the population.

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