Perspective               

The Medicare Drug Benefit Could Exclude Many Seniors If Based Only on Income

The idea that people with low incomes should receive help with paying for prescription drugs is popular among Americans. But we must wonder-is a person's income level the best way to assess need for Medicare drug coverage assistance?

A new study released by The Commonwealth Fund suggests that if people were given a Medicare prescription drug benefit based on their income alone, many needy Americans with Medicare would be stranded without drug coverage. In fact, if coverage were restricted to older adults and people with disabilities who have annual incomes at or below the federal poverty level, only about one-fourth of them would receive federal assistance for prescription drugs.

The study indicates that a person's need for consistent and stable drug coverage should not be only tied to income level. The Commonwealth Fund suggests that several other factors be considered when determining a person's eligibility for a Medicare prescription drug benefit. These factors include lack of access to affordable coverage, lack of stable coverage, high out-of-pocket costs, total drug spending, and a chronic disease burden.

The share of people with Medicare meeting any one of these criteria ranges from less than 10 percent to almost 50 percent. Expanding the definition of need to include those without continuous and stable coverage, those with high expenditures, and those with several chronic conditions, for example, could qualify 90 percent of older and disabled Americans for the drug benefit.

To learn more about the study, go to the Commonwealth's Web site at www.cmwf.org. If you need help paying for your prescription drugs, go to the Prescription Drug Assistance Program Compare site at www.medicare.gov for information on how to find assistance programs in your area. If you don't have Internet access, visit your local library. Most libraries now have Internet access. You may also call your State Health Insurance Assistance Program, or SHIP, for advice. The number is listed in Medicare & You or you can call 1-800-MEDICARE.

_________________________________