Medicare Part D, the prescription drug benefit for seniors, now offers an online service for beneficiaries. Called "Plan Finder," it allows seniors to find and compare prescription drug plans. This user-friendly online tool is just one of the ways Medicare Part D is helping seniors make informed decisions about their health care -- and save money.
More than 25 million Part D participants fill more than 100 million prescriptions each month, and more than 85 percent of beneficiaries consistently report being satisfied with their coverage.
Notably, costs to taxpayers and enrollees are substantially lower than first predicted, thanks in part to the healthy competition the program is built upon.
Today dozens of private companies across the country offer more than 1,800 approved Medicare Part D plans. And on average, premiums are about $28 per month -- 37 percent lower than anticipated when Part D was created six years ago. Plus, the cost of the program to taxpayers this year will be about $30 billion less than first projected.
With so many competing plans, though, many beneficiaries find it difficult to pick the one that's right for them. The plans vary in lists of approved drugs and treatments, premiums, deductibles, and out-of-pocket maximums. Additionally, the plans differ in how they deal with the infamous "donut hole." That is the gap in drug coverage where beneficiaries have used up their basic drug benefit, but have not yet reached the point where Medicare's "catastrophic coverage" kicks in.
This is why Medicare's online resources so valuable. The website allows users to find and compare plans, assessing how they will change next year and potentially helping them to identify a plan that may better suit their medical or budgetary needs.
Seniors need only make a list of all their current prescriptions and dosages, then head to www.Medicare.gov. After entering this information on the website, "Plan Finder" kicks out a list of all the appropriate insurance plans and their costs in the area.
Users can even compare the cost of filling prescriptions by mail versus buying directly from a local retail pharmacy. This is especially useful for seniors who take several prescription drugs.
There are other innovations coming to Medicare Part D next year as well that will further build upon the program's success and help seniors make smart, informed decisions about their health care.
In 2010, the use of medication therapy management programs (MTMPs) will be greatly expanded and improved. MTMPs save both money and lives by improving drug adherence amongst patients, better educating patients about their medications, improving prescribing, and watching for potentially dangerous drug interactions.
Unfortunately, there's a campaign underway in Congress to restructure Part D to allow the government to "negotiate" drug prices with pharmaceutical firms. This would turn Part D into a more traditional government program with just a single, price-controlled plan.
Under the drug benefit administered by the Department of Veterans Affairs (VA), for example, the government "negotiates" prices by telling drug manufacturers that they have to sell to their drugs to the VA at a price that is at least 24 percent less than the non-Federal Average Manufacturer Price. If companies refuse to comply, the drug they refuse to "negotiate" on is banned from Medicaid and Medicare, as well as the VA benefit.
Consequently, most companies comply. The VA purchases just small percentage of the drugs the nation consumes, so drug companies can afford the loss. Plus, no drug company wants to find itself barred from Medicare and Medicaid. That said, many companies simply can't afford to sell their drugs at such discounted rates. So the VA offers far fewer drugs than Medicare Part D.
If such price controls were extended to Medicare, though, seniors would undoubtedly be left with fewer drug options -- and compromised health.
By taking the opposite approach, Medicare Part D leverages market forces to create competition, leading to lower prices, better service, and more choices.
Because Medicare itself has been around for decades, it is sometimes easy to forget that the prescription drug benefit is still in its infancy. But it's growing up nicely, thanks to the active participation of millions of seniors and the healthy competition that was smartly designed into the program. Beneficiaries should utilize the many tools Medicare makes available to them to make educated decisions about their coverage and their health.
Robert Goldberg is vice president of the Center for Medicine in the Public Interest.