Because Medicare does not cover outpatient drugs, Ms. Jones and millions like her must struggle to pay for needed medications or, in some cases, do without. Although a majority of beneficiaries have some type of drug benefit from a Medicare HMO plan, Medicaid, or private insurance, the level of coverage varies widely. More than 10 million Medicare recipients have no prescription coverage at all, and another 7 million are covered only part of the time. The financial burden is only part of the story. An untold number of prescriptions are never filled because patients cannot afford them.
Some patients skip doses or cut pills in an effort to save money.
Interest in a Medicare drug benefit is growing on the political front. In June, President Clinton unveiled a plan to give limited prescription drug coverage to all 39 million elderly and disabled Medicare beneficiaries. A timely new study commissioned by The Commonwealth Fund will help provide the answers. That knowledge is essential in assessing the costs and benefits of any Medicare drug benefit. The Commonwealth Fund plans to publish several issue briefs and papers throughout the course of the project to help inform policy-makers.