Medicare

Nearly 3 million Medicare Part D enrollees had out-of-pocket prescription drug spending above the catastrophic threshold in a recent 5-year period. While the Part D drug benefit has helped make drugs more affordable for people with Medicare, the lack of a hard cap on annual out-of-pocket spending under Part D exposes enrollees to significant costs, unless they qualify for low-income subsidies. Medicare Part D enrollees with out-of-pocket spending above the catastrophic threshold spent $7.4 billion out of pocket for prescriptions filled in the catastrophic phase between 2015 and 2019. Policymakers on both sides of the aisle support proposals in the House and Senate to modify the design of the Part D benefit and establish a hard cap on out-of-pocket drug spending by enrolleees.

Rates of cost-related problems are higher among beneficiaries in Medicare Advantage than in traditional Medicare with supplemental coverage, but highest among beneficiaries in traditional Medicare without supplemental coverage. Among Black beneficiaries specifically, a larger share of those in Medicare Advantage reported cost-related problems than those in traditional Medicare (32% vs. 24%). The rate of cost-related problems was lower still among the subset of Black beneficiaries in traditional Medicare who had Medicaid or other sources of supplemental insurance (20%).

Older Americans, a group hit disproportionately hard by the coronavirus pandemic, are now among those in the U.S. who are most likely to have been vaccinated against COVID-19. Nevertheless, our new county-level analysis finds that rates of fully vaccinated older adults vary considerably across the country. Rates tend to be lower in counties with a higher share of seniors in poverty, counties located in the South, and counties with a higher share of adults who voted for Trump.

Fifty-seven percent of Medicare beneficiaries do not review or compare their coverage options annually – a decision that can lead to unanticipated costs or coverage disruptions as beneficiaries pick Part D stand-alone drug plans and Medicare Advantage plans. Medicare’s annual open enrollment period runs from October 15 through December 7.