Medicare Drug Plans Are Restricting Access to Medicine

A recent investigation has found another serious problem with the Medicare drug benefits.

An Investigative report reveals that Medicare drug plans are restricting access to drugs that are listed as available through their programs. The report, released by the office of Henry Waxman, Democratic Representative from California, says that a vast majority of Medicare Drug Plans use prior authorization, "step therapy", or "volume limits" to deny access to medicine. To make matters worse, disclosure of these terms is "virtually nonexistent."

The investigation for this report found that 97% of Medicare drug plans place restrictions on at least one of the 100 most prescribed drugs and some plans restrict access to over 40 of these medications.

A phone survey found that over two thirds of the plans contacted were not able to describe accurately how any of these restrictions worked. In many cases, plan representatives had no idea what these terms meant. The drug plans also gave erroneous and conflicting information. In some cases, representatives of the drug plans said that information on the restrictions was available only after signing up for the plan.

Seniors are being asked to choose from a bewildering number of Medicare drug plans but a careful review of the plans is not an accurate guide to the availability of drugs. Add to this picture the fact that the plans may drop medicines from their coverage at any time but enrollees can change plans only once a year and its clear that many seniors are facing a serious predicament.

To read the full text of the report go to: http://www.democrats.reform.house.gov/story.asp?ID=1028

Created 3/25/06