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Volume 27, Issue 462 |
March 6, 2006 |
STATES VARY WIDELY IN NUMBERS OF
BENEFICIARIES WHO ARE GETTING DRUG BENEFITS
Just over half of the 43 million Medicare beneficiaries who are eligible for the new Medicare Part D prescription drug benefit are getting prescription drug benefits, according to figures released Feb. 22 by the Centers for Medicare & Medicaid Services and analyzed by the Henry J. Kaiser Family Foundation.
The Kaiser-sponsored chart below provides a state-by-state breakdown of the numbers of beneficiaries who have, or don’t have, prescription drug coverage. Those with coverage are enrolled in a stand-alone prescription drug plan (PDP) for drug coverage only, a Medicare Advantage plan, were dual eligibles who were auto-enrolled in a PDP, or receive drug coverage through a retiree drug benefit plan.
The majority of those with “creditable” coverage (see chart) most likely had drug coverage prior to 2006 from employer plans, Medicaid or Medicare Advantage pans, Kaiser notes. CMS projected that 29.3 million beneficiaries would be enrolled in Part D in 2006.
- Meanwhile, another Kaiser-sponsored report on states’ experience with enrollment of dual eligibles found:
- Over 60 percent of states reported problems that affected a significant number of dual eligibles;
- 37 states implemented temporary coverage programs for dual eligibles or Part D enrollees experiencing problems; and
The most common problems included incorrect cost-sharing charged to beneficiaries (49 states), pharmacies that could not bill plans (44 states), and beneficiaries who were unable to obtain non-formulary drug (43 states).
For more information, visit Kaiser's resources on the Medicare drug benefit at http://www.kff.org/medicare/rxdrugbenefit.cfm.
For more news on 2006 prescription drug state legislation, visit this new NCSL report. It describes about 400 pending bills in 40 out of the 44 states with 2006 sessions, including five already signed into law. Covered topics range from Part D wrap-around plans and state Rx discounts, to price disclosures and regulation of PBMs, wholesalers and internet sales. For future editions, the NCSL researchers welcome any updates from state staff covering these issues. Replies by email may be sent to madeline.kriescher@ncsl.org
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