Author Affiliation: Department of Health Care Policy, Harvard Medical School, Department of Health Policy and Management, Harvard School of Public Health, and Kennedy School of Government, Harvard University, Boston, Mass.
The recent rapid increase in both the pharmaceutical armamentarium and
drug spending has made the anachronism of no Medicare outpatient drug benefit
an increasing burden for Medicare beneficiaries. Not surprisingly, discussions
of a new Medicare drug benefit are prominent on the current political agenda.
Despite the lack of coverage in the program, more than half of Medicare
beneficiaries have some coverage for drugs, which they obtain through 1 of
4 sources: supplemental or retiree health insurance through a former employer;
Medicaid; individual Medigap policies that cover drugs; or managed care organizations.
In 1995, the proportions of beneficiaries who obtained coverage for drugs
through these 4 sources were 31%, 12%, 11%, and 7%, respectively. However,
in light of the growth in managed care enrollment since 1995, the proportion
of Medicare beneficiaries who obtain coverage for drugs through managed care
organizations is probably around 10% today.1
Newhouse JP. Switching Health Plans to Obtain Drug Coverage. JAMA. 2000;283(16):2161-2162. doi:10.1001/jama.283.16.2161