Who Failed To Enroll In Medicare Part D, And Why? Early Results

Abstract

Early results on the Medicare Part D prescription drug program, from a survey of people age sixty-five and older who were interviewed just before enrollment started and just after it ended, indicate that Medicare has met its target of 90 percent coverage. Enrollment rates in vulnerable subpopulations-poor health, low income, or cognitive impairment-are almost high enough to offset lower rates of other coverage. However, sizable numbers of elderly people remain uncovered, contrary to their self-interest. Seniors give Part D mixed reviews, and majorities are less satisfied with Medicare and with the government as a result of their experience with this program. [Health Affairs 25 (2006): w344-w354; 10.1377/hlthaff.25.w344] E n r o l l m e n t i n t h e f i r s t o u t pat i e n t d ru g coverage benefit in Medicare's history began 1 January 2006, following the passage of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. A much-publicized enrollment deadline passed 15 May 2006, after which most seniors face penalties for late enrollment. This paper presents early results on the demographics of enrollment in the Medicare Part D prescription drug program, based on the Retirement Perspectives Survey (RPS) conducted by our research group before and after the enrollment deadline. closed.2 Respondents were asked about their Part D knowledge and intentions in the first interview and about their enrollment-process choices and opinions in the second interview. We present results primarily from a core of 1,571 respondents who were age sixty-five and older in May 2006, were eligible for Part D, were interviewed in both waves, and had no item nonresponse on key variables.The RPS was administered to a panel of subjects enrolled by Knowledge Networks, a commercial survey firm. Panel members were representative of the U.S. resident population in terms of demographics and socioeconomic status, and sample weighting was used to adjust for subsequent nonresponse.3 They were interviewed using supplied Web TV hardware. Respondents are somewhat more computer-literate than the underlying population: About half of the panel members use the Internet, compared with about a third in the corresponding population. 4 Panel members were compensated for participation. In addition to questions about Medicare Part D, each RPS interview contained questions and embedded experiments regarding health status and conditions, long-term care choices, prescription drug use and cost, and attitudes toward risk. 5Additional socioeconomic and demographic variables were provided by Knowledge Networks as background on panel members. We also constructed a simple index of cognitive impairment. Study ResultsOf the 35.84 million people age sixty-five and older who reside in the United States and are eligible for Medicare Part D, data from the Centers for Medicare and Medicaid Services (CMS) suggest that as of 14 June 2006, 24.67 million (68.9 percent) were enrolled in Part D, 8.50 million (23.7 percent) had other credita...

Plan Selection in Medicare Part D: Evidence from Administrative Data

“…We begin our analysis of the administrative data on Medicare Part D by looking at the enrollment decision; this complements earlier research that used survey data such as Winter et al (2009) and Heiss et al (2006Heiss et al ( , 2009. The Part D program is heavily subsidized, with insurers reimbursed from government general revenues for about 75 percent of overhead and benefits paid out, with fairly tightly regulated formulary and benefit design and competitively determined premiums.…”

Impact of an Elective Course on Pharmacy Students’ Attitudes, Beliefs, and Competency Regarding Medicare Part D

“…4,5 Beneficiaries complained of having too many Part D plans from which to choose and expressed fear that if they changed plans, they might not make the optimal choice. 6 This fear caused many to simply ''make do'' with their current plan.…”

The Impact of the Medicare Part D Prescription Benefit on Generic Drug Use

“…Early studies of the program have focused on its uptake 2 and beneficiary reaction to the benefit 3 , while other reports have examined how the benefit has impacted prescription drug expenditures among those who have enrolled in Prescription Drug Plans (PDPs) 4 . However, few studies have been performed examining the impact of the benefit on prescription drug utilization among a broad population of Part D enrollees and nonenrollees alike.…”