Drug Coverage Options for Poor Medicare Recipients Dwindle

Posted by Vanessa Fuhrmans in the Wall Street Journal Health Blog Low-income Medicare beneficiaries are starting to look a lot like the girl no one wants to take for a spin on the dance floor. In a growing number of states, many will have fewer drug plans to choose from next year. Only 308 Medicare drug plans have qualified to serve low-income beneficiaries in 2009, almost 200 fewer than this year. That means about 1.3 million people will have to be reassigned to another plan, up from the 1.2 million that Medicare shifted to new plans in 2008 and just 250,000 in 2007. In six states — Arizona, Florida, Hawaii, Maine, Nevada and New Hampshire–low-income seniors will have five or fewer drug plans to choose from, according to an analysis by Avalere Health, a Washington-based research and consulting firm. In Nevada, low-income beneficiaries will have only one stand-alone drug plan available; in Arizona, two. The government automatically assigns a chunk of these 6 million people, who are eligible for both Medicaid and Medicare, to the Medicare drug plans of companies whose premiums are lower than the average. Then the government subsidizes the costs of the plan. That combination encouraged plan providers like Humana and others to compete hard with low prices and give poor Medicare members an array of plan choices. But for many companies, making money on these folks has proved harder than originally thought, despite the subsidies. The result, Avalere says, is that many previously low bidders are now among the highest, and that’s going to lead to a major upheaval next year. Avalere points out that could leave some of those enrollees, many who are among the sickest Medicare members, in a plan with a drug formulary that doesn’t cover all of their health care issues.