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Low-Income Seniors Skimp Less on Prescription Drugs
With State Help
SeniorCare programs reach further than Medicare 2006
in Wisconsin, Illinois
June 20, 2005 – A new study by Brandeis University
researchers shows that two state-run pharmacy assistance programs
reduced by one-half the number of senior citizens who either forgo
necessities or skimp on prescribed drugs. Moreover, the decline in
skimping was most dramatic among the most vulnerable – those with
advanced age and multiple chronic conditions, the study concluded.
Joann Schroeder's chronic health conditions force
the retired receptionist to take several medications costing thousands
of dollars yearly. But with Social Security checks totaling less than
$1,100 monthly, the 70-year-old Wisconsin resident struggled to pay for
prescriptions outright. Paying by credit card worked until mounting debt
– more than $4,000 in drug costs – made her realize that strategy was on
a collision course with economic reality.
That was three years ago. Since then Schroeder has
been covered by SeniorCare, Wisconsin's prescription drug assistance
program implemented in 2002. "If SeniorCare hadn't come along, I would
have had to use yet another credit card – and where would that have
gotten me?" she said.
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Wisconsin SeniorCare |
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SeniorCare is a prescription
drug assistance program for Wisconsin residents who are 65 years
of age or older who meet the eligibility criteria. The program
is designed to help seniors with their prescription drug costs.
Those interested may apply at any time. The Department of Health
and Family Services (DHFS) administers the SeniorCare program.
To be eligible for SeniorCare:
> You must be a Wisconsin
resident.
> You must be 65 years of age or older.
> You must pay a $30 annual enrollment fee per person.
> Your assets, such as bank accounts, insurance policies,
home property, etc., are not counted.
> Your annual income determines the level of coverage.
In addition, program
participants are subject to certain annual out-of-pocket expense
requirements depending on their annual income, as shown in the
table on the Website. Drug coverage may vary by Level.
Click Here to the Wisconsin program fact sheet.
Click Here to
SeniorCare in Illinois |
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Schroeder managed to avoid "skimping" on drug
costs, but only by racking up debt. For other seniors, forgoing
necessities or skimping – either skipping doses or splitting them -is an
inevitable consequence of poverty and chronic illness. Illinois also
began a similar SeniorCare program earlier the same year.
More than one-quarter of those surveyed skimped
before assistance program
"Overall, it's a huge improvement – but it's not a
100 percent cure," explained lead study author Donald Shepard, professor
at The Heller School for Social Policy and Management at Brandeis.
"Seniors still face co-payments for prescriptions, enrollment fees,
deductibles, and other barriers such as transportation costs to the
pharmacy or their physician."
The study randomly surveyed 2,227 participants in
the SeniorCare programs in Wisconsin and Illinois. The programs are open
to seniors whose annual income is at or below 200 percent of the federal
poverty level, about $20,000. The study found that having several
chronic non-life-threatening conditions was associated with a higher
probability of skimping, while life-threatening conditions resulted in a
lower risk of skimping.
Brandeis study sheds light on scope of skimping
"Wisconsin didn't have its own data on skimping so
we didn't know how pervasive it was, said Russell Pederson, Wisconsin
SeniorCare program director. "The Brandeis study is important to policy
makers in Wisconsin and Washington because it gives us hard data on the
scope of the problem," Pederson added.
The overall share of skimping among seniors was
28.4 percent before SeniorCare, and 12.9 percent after enrollment in the
assistance program, a reduction of 55 percent. Similarly, the study
showed that the proportion of seniors going without some necessities was
cut by more than one-half, from 35.4 percent before SeniorCare to 17.0
percent after SeniorCare, a reduction of 52 percent.
The Brandeis study, funded by the Centers for
Medicare & Medicaid Services, is being presented at the AcademyHealth
Annual Research Meeting in Boston on June 26.
For most seniors, Medicare drug benefit will be
less generous than state program
In January 2006, Medicare will offer its
prescription drug benefit, known as Part D, for all seniors. These
SeniorCare programs, created by federal waivers in 2002, expire in 2007.
The federal benefit is not expected to be as generous as SeniorCare for
most seniors.
"Medicare Part D would probably achieve comparable
benefits for those whose income is below 135 percent of the federal
poverty level, or about $14,000, "said Professor Shepard, adding, "but
for those whose incomes are above this threshold, Part D has very
significant cost sharing and ceilings, so these seniors may still face
formidable challenges in paying for prescription medicines."
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