Heart Health Articles

Seniors Still Uncertain About New Prescription Drug Benefit, Highlighting Importance of Ongoing Education, Survey Finds, USA

November 21, 2017

With less than one week before enrollment in the new Medicare drug benefit is scheduled to begin, many seniors remain uncertain about the new coverage and undecided about whether they will enroll, according to a survey released Thursday by the Kaiser Family Foundation and the Harvard School of Public Health, the Akron Beacon Journal reports (Powell, Akron Beacon Journal, 11/11). The survey, conducted Oct. 13 to Oct. 31, includes responses from 802 seniors. It has a margin of error of plus-or-minus 3.5 percentage points (CQ HealthBeat, 11/10). According to the survey, 61% of seniors say they understand the new benefit "not too well" or "not at all," while 35% say they understand it "very" or "somewhat" well (Washington Post, 11/11). Seniors' knowledge of important elements of the new benefit varied, with the majority correctly stating that most seniors will need to sign up for coverage. However, more than four in 10 seniors say they do not know if there are financial penalties for late enrollment or report incorrectly that there are no penalties (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10). Forty-nine percent of seniors say they do not think the drug benefit will help them personally, compared with 39% who say it will, the survey indicates (Alonso-Zaldivar, Los Angeles Times, 11/11). Forty-three percent of seniors say they have not yet decided whether to sign up for the benefit, while 37% say they will not enroll and 20% say they will, according to the survey (Appleby, USA Today, 11/11). Those without existing drug coverage are more likely to say they will enroll than those with existing drug coverage, the survey indicates (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10).

Additional Results
Meanwhile, only 5% of seniors are aware that they will have more than 20 different plan options from which to choose, the survey shows. When informed that the government has announced that most people will have at least 40 drug plans to choose from, nearly three in four seniors say having many available plans makes it "confusing and difficult to pick the best plan" (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10). When asked about their overall views of the drug benefit, 37% of seniors say they have an unfavorable view of it, compared with 31% who view it favorably (Freking, AP/Rochester Democrat and Chronicle, 11/10). Thirty-one percent of seniors say they do not know how they view the drug benefit (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10). Seniors who say they understand the benefit are more likely to report a favorable view of it, according to the survey. In addition, 77% say they believe the drug benefit will help low-income seniors (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10). However, 50% of those most likely to be eligible for financial help under the benefit are unaware that they might qualify, according to the survey (Los Angeles Times, 11/11). Among those who now plan to enroll, 35% say the most important factor in determining which plan they choose will be how much they pay out of pocket for prescriptions, compared with 19% who cite "which drugs the plans cover," and 16% who cite "how much the plan charges for monthly premiums." Seniors most often say they "very likely" will turn to their personal doctor or the Medicare program itself for help making decisions about the drug benefit, while fewer say they will seek help from their pharmacist, the Social Security Administration, friends and family members, or a seniors' group or community organization (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10). In addition, more than half of seniors say their pharmacists and doctors are likely to help them choose a drug plan (Reuters/Newark Star-Ledger, 11/11). Most seniors expect their providers to be knowledgeable about their options (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/10).

Educational Efforts Improving
The survey also shows that seniors are receiving more information about the new drug benefit. Seventy-four percent say they have received such information, and of those, 60% say they have read through it closely. About half of seniors say they have received information about the benefit from CMS, up from 26% in August (CongressDaily, 11/10). Forty-five percent of seniors say they have seen or heard television or radio advertisements about the benefit. In addition, 50% of seniors say they have heard of the 1-800-MEDICARE hotline -- and 8% have called the number -- while 35% say they have heard of Medicare (Kaiser Family Foundation/Harvard School of Public Health joint release, 11/9). Only 6% of seniors have visited the Medicare Web site, the survey shows (Olson, St. Paul Pioneer Press, 11/11). Overall, 76% of seniors say they have never used the Internet, according to the survey (USA Today, 11/11).

"We're less than a week away from enrollment, and it's not really clear whether most seniors will jump in the pool or sit on the sidelines," Kaiser Family Foundation President and CEO Drew Altman said, adding, "If it was completed next week, most wouldn't enroll." Altman added, "The success or failure of this law is up for grabs. It will depend on the ability of the government and private plans and community organizations to provide one-on-one assistance to 43 million seniors across the country who are struggling with one really big question: 'What does this mean for me and should I enroll?'" (Krasner, Boston Globe, 11/11). Mollyann Brodie, a Foundation vice president and director of public opinion and media research, said, "About three in four seniors expect to lean heavily on their doctors and pharmacists to guide them through their options, but those expectations may not be realistic" (Moos, Dallas Morning News, 11/11). Robert Blendon, a professor of health policy at Harvard, said, "If people had to make a selection today, a large number would not do so. Some of them are going to say, 'This is just too confusing for me. I'm just not going to do anything'" (Akron Beacon Journal, 11/11).

Comments From Leavitt, McClellan
"It's going to take time for seniors to become comfortable with the choices they have," HHS Secretary Mike Leavitt said, adding, "Enrollment may start out slowly. But we're confident that over time seniors are going to like the benefit" (Pugh, Knight Ridder/Contra Costa Times, 11/11). Leavitt noted that the "feedback [CMS is] hearing on the road has been extremely positive" (CQ HealthBeat, 11/10). CMS Administrator Mark McClellan said, "When you look at the people who say they don't plan to enroll, it's mainly because they already have coverage." He also said the public's view of the new drug benefit "depends a little bit upon which survey you see," adding, "I can get five other numbers from other places that show a lot of interest in enrolling among people who don't have coverage now" (AP/Rochester Democrat and Chronicle, 11/10). CMS spokesperson Roseanne Pawelec said, "Recent surveys done by CMS and other groups show that awareness of the drug coverage has increased dramatically, more people are talking about the drug coverage with someone they know, and there is strong interest in enrollment, especially among Hispanic and African Americans" (Boston Globe, 11/11). According to the Beacon Journal, CMS officials highlighted an online survey of 290 seniors published on Thursday by the Wall Street Journal Online and Harris Interactive that found about half of seniors say they likely will enroll in the Medicare drug benefit (Akron Beacon Journal, 11/11).

Additional Reaction
Robert Hayes, president of the Medicare Rights Center, said the survey's findings "reflect every consumer call we get. ... Virtually everyone is in a state of upheaval and ... frustration, and it's extremely difficult for the best experts to provide meaningful help" (CQ HealthBeat, 11/10). Ron Pollack, executive director of Families USA, said, "The survey underscores the fundamental flaws of the new Medicare legislation. Those flaws are producing bewilderment and confusion among seniors and will result in a far more costly program for America's seniors and taxpayers" (Boston Globe, 11/11). John Rother, director of policy and strategy for AARP, said it is not surprising that seniors are unsure about the new benefit. "This was a program enacted as part of a very high-profile, partisan controversy," Rother said, adding that "the benefit is not what people had hoped to see" (AP/Rochester Democrat and Chronicle, 11/10). He said, "If only 20% or even 30% of seniors sign up, that is very negative for the future of the program, because the people most likely to sign up are the people with high drug expenses, and you don't have insurance if you don't spread the risk among people who are healthy" (Los Angeles Times, 11/11). Cheryl Matheis, director of health strategies integration for AARP, noted that other studies have contradicted the survey's findings, adding that when AARP conducts educational sessions on the new benefit, "people are very interested in finding out about it. That's the message we're getting" (CQ HealthBeat, 11/10).

The survey results are available online.

A webcast of a briefing to release the report also is available online.

Broadcast Coverage
NPR's "Morning Edition" on Friday reported on CMS' launch on Nov. 7 of its Internet tool that allows beneficiaries to compare prescription drug plans available under the new Medicare drug benefit and a report by the HHS Office of Inspector General finding that millions of seniors and disabled people likely will need help enrolling in the benefit. The segment includes comments from Deane Beebe, director of communications at the Medicare Rights Center; Blendon; Mary Agnes Laureno, director of CMS' Beneficiary Information Services Group; and McClellan (Rovner, "Morning Edition," NPR, 11/11).

The complete segment is available online in RealPlayer.

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