As overall health care costs rise, many employers are reducing the extent of coverage or increasing employee cost-sharing. This could mean changes in drug benefits. These are privately-purchased insurance plans which are designed to cover items which Medicare does not. Three of the ten standard Medigap plans include a prescription drug benefit. The cost of Medigap policies puts them beyond the reach of many seniors.
All plans require a substantial co-payment and cap benefits.
These plans do not help persons with catastrophic prescription expenses. Since 1997, the federal government has encouraged HMOs to offer plans to cover seniors. Prescription drug benefits offered by Medicare HMOs vary widely. Very low-income seniors may qualify for some type of Medicaid assistance. Although a prescription drug benefit is an optional service, most states and territories provide such assistance.