Presentation on theme: "Medicare and Prescription Drugs: Issues for Employers and Consumers Robert D. Reischauer The Urban Institute National Health Policy Conference January."— Presentation transcript:
Medicare and Prescription Drugs: Issues for Employers and Consumers Robert D. Reischauer The Urban Institute National Health Policy Conference January 28, 2004
Decisions for Employers that Currently Provide Retiree Drug Coverage
#1. Which Option? Take 28% subsidy (expenditures $250 - $5,000) Establish closed DIMA-style plan Drop coverage
#2: For First Option: Whether to Redesign Current Drug Benefit? To maximize government subsidy To take advantage of generous government catastrophic coverage To share windfall with retirees
#3: What Carrots, if any, to Provide with Options 2 and 3? Pay Rx premiums Pay premiums for non Rx retiree coverage Reduce non Rx cost-sharing Increase cash pension benefits
#4: Whether to Change Worker Coverage to Take Advantage of HSAs
What Impacts Will These Decisions Have On: The distribution of costs between employers and retirees? The distribution of costs between employers and workers? Retirees/workers with large vs. small health expenditures?
Decisions for Beneficiaries
#1: Whether to Participate in the Discount Card Program in 2004-5?
#2: Which Discount Card Program? Inclusion of beneficiarys own Rx in formulary Depth of discounts on beneficiarys own Rx Breadth of formulary and depth of average discount Breadth of pharmacy network Membership fee
#3: Whether to Apply for the $600 Low-Income Subsidy?
#4: Whether to Participate in the Full Rx Benefit Program after 2005? Expected Rx expenditures now and in the future Types of plans that are available (stand alone regional PDPs, fallback plan, local MA plans, regional MA PPOs, national PDPs) Formularies/premiums/cost-sharing Penalties for late enrollment
#5: Whether to Apply for Low-Income Subsidies? Asset test
Who Will Provide Information to Help Beneficiaries Sort Through Their Choices? CMS? Advocates for Seniors, AARP, Families USA, etc.? Mainstream media? Health providers? Others?