Medicare Beneficiaries, Especially Unsubsidized Minorities, Struggle to Pay for Prescription Drugs: Results from the Medicare Current Beneficiary Survey

Excerpt

In 2006, Medicare started offering outpatient prescription drug benefit—Part D—with significant cost sharing, including a coverage gap (“donut hole”) that required patients to pay the full cost of drugs while in the gap and up to 5% cost sharing after patients reach the catastrophic coverage limit (> $5100 in 2019). Nearly 1 in 10 Part D enrollees had drug spending above the catastrophic coverage threshold in 2015, a quarter of whom did not receive low-income subsidies (LIS) and encountered an average out-of-pocket spending of $3041 annually.¹ High cost sharing can lead to cost-coping behaviors such as delaying medication refills, switching to lower-cost alternatives, and spending less on other necessities. Two previous studies on a regional Medicare Advantage (MA) population shortly after Part D went into effect in 2006 found that 26–36% reported at least one cost-coping behavior.^{2, 3} Cost sharing in Part D can create greater financial barriers for minorities and lead to more cost-coping behaviors, as they tend to have lower income than their white counterparts. It is currently unknown if there is any racial/ethnic disparity in prescription drug cost-coping behaviors among Medicare beneficiaries nationally. …