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Less Than 18% of Low-Income Seniors Approved for
Medicare Drug Subsidies
Only 1 million of up to 6.6 million approved by
Social Security
Jan. 6, 2006 - The new Medicare prescription drug
program which began on January 1 is leaving at least 4.7 million
low-income seniors without the benefits to which they are entitled,
according to a Families USA. The organization reports the Social
Security Administration has only approved one million low-income seniors
out of a pool of 5.7 to 6.6 million to receive low-income drug
subsidies.
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Now that the benefit has begun, this is no longer a
question of what could happen but a question of what is happening to
millions of low-income seniors who aren't getting the help they need.
Without such subsidies, purchasing needed medicines is simply
unaffordable for those low-income seniors, says Families USA.
"It is truly disappointing to see such a large
number of low-income seniors not get the benefits to which they are
entitled to," said Ron Pollack, Executive Director of Families USA.
"These are people who need help the most and are not getting it.
"When the new Medicare legislation was enacted, the
White House and congressional leaders touted its benefits for low-income
seniors. Unfortunately, the vast majority of those seniors have been
left behind without the help that they need."
During the past few months, very little attention
has been given to the complexity of the special drug coverage and
subsidies intended for low-income seniors, the organization says.
Three categories of low-income seniors were
established under the new Medicare legislation, and each group will
receive different benefits and will be enrolled through separate
processes:
1. Non-Medicaid Low-Income Beneficiaries:
Between 5.7 and 6.6 million low-income seniors and people with
disabilities who receive no Medicaid benefits were projected by the
Congressional Budget Office to be eligible for special drug subsidies
under the new Medicare legislation. To qualify, they need to have
incomes below 150 percent of the federal poverty level ($14,355 in
annual income for a senior living alone, $19,245 for couples), and they
must proactively apply for this benefit. The actual amount of the drug
subsidies provided to these beneficiaries varies based on their income
and assets.
2. The So-Called "Dual Eligibles": This is a
group of approximately 6.4 million low-income Medicare beneficiaries who
currently participate both in Medicare and Medicaid. This group has been
receiving drug coverage through the Medicaid program, but Medicaid
stopped providing such coverage on December 31. Since this group is
readily identifiable, any dual eligible person who did not voluntarily
enroll in a private Medicare drug plan by January 1 was automatically
enrolled by the government in a plan and will receive the low-income
subsidy. It is very likely, however, that a significant portion of those
automatic enrollees were placed in a private plan that does not cover
their medicines - thereby making them worse off than they were before
the new Medicare drug program began.
3. "Medicare Savings Program" Participants:
Between 1.1 and 2 million beneficiaries have slightly higher incomes
than dual eligibles and receive Medicaid subsidies to pay for their
Medicare premiums and cost-sharing. Since these low-income people are
also readily identifiable, those who do not voluntarily enroll in the
program will be automatically enrolled by May 15 in a plan and will
receive low-income subsidies.
"The complexity of the Part D benefit has almost
certainly discouraged potentially eligible low-income beneficiaries from
applying," said Pollack. "Low-income seniors not only have to navigate
through the maze of their Part D options, but they also have the added
burden of having to apply to a separate government agency for the
subsidy."
About Information Source:
Families USA is the national organization for health care consumers. It
is nonprofit and says it is nonpartisan and advocates for high-quality,
affordable health care for all Americans. E-mail:
info@familiesusa.org - Web site:
www.familiesusa.org
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