Is Medicare Really Working in Oregon?

Kathy Hahn, PharmD, is a licensed pharmacist and pharmacy manager. She chairs the Oregon Pain Management Commission, and is credentialed as a Pain Practitioner with the American Academy of Pain Management, as well as certified with the American Society of Pain Educators.

By Kathy Hahn, PharmD

This summer’s news about the Supreme Court’s decision to uphold all of the major pieces of the 2009 federal Affordable Care Act was a welcome sign for Oregon’s Medicare enrollees.  The availability of Medicare’s Part D prescription benefit, since its launch six years ago, has provided tens of millions American seniors and disabled individuals – 625,000 of them in Oregon; 16 percent of our state’s population – with the security of access and affordability of needed medications.

 

Nationally, of the more than 40 million people on Medicare, 90 percent currently have comprehensive prescription drug coverage, thanks to Medicare Part D. The Journal of the American Medical Association recently found that improved access and adherence to medicines through Part D saves Medicare about $1,200 per year in hospital, nursing home and other costs for each senior who previously lacked comprehensive drug coverage. This translates into about $12 billion per year in savings across Medicare.

 

And the good news is that many surveys are finding seniors are generally happy with their benefits. Medicare Part D enrollees – about 1 in 10 – are overwhelming satisfied with this program, as found in the survey by Medicare Today. (You can read the survey at http://www.medicaretoday.org/Medicare%20Today%202011%20KRC%20survey%20release.pdf.)

 

One certain reason enrollees are continually satisfied is that 2012 premiums are lower on average than 2011 premiums.  In 2011, the Centers for Medicare and Medicaid Services (CMS)  found that the Medicare Part D program saved enrollees $2.1 billion in 2011 because of the Gap Discount program, which requires drug manufacturers to provide discounts on brand-name and generic drugs to seniors in the gap or “donut hole.”  About 3.6 million enrollees nationwide benefitted from these discounts, at an average of $604 each.

 

Also key is that the Affordable Care Act’s provisions for Medicare will further protect enrollees now that we know the 2013 premium rate for Part D stands at $30, which is virtually unchanged over the past three years, and 50 percent lower than initial cost projections. Medicare Part D can keep doing its good work, with the variety of options of coverage for basic or more complex prescription benefits, which gives enrollees maximum choice and flexibility.

 

It’s important for seniors and beneficiaries to know this now, because open enrollment just started on Oct. 15, so there’s plenty of time to review plans and selections to ensure Medicare Part D keeps doing its job for you or your parents. Enrollment starts earlier this year and ends earlier, too, on Dec. 7.

 

For Oregon’s beneficiaries, your voices are the most important in this discussion to preserve and protect Medicare for the present needs and for our future generations.