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Medicare Part D coverage is a
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placeholder November 7, 2016   •   VOL. 54, NO. 19   •   Oakland, CA
Senior Living & Resources

Medicare Part D coverage is a home run

Medicare open enrollment is here — and it's time for older adults to step up to the plate.

From now until Dec. 7, they can sign up for Medicare coverage, switch out of their current health plan for a new one or add prescription drug coverage through Medicare Part D.

Adding Part D coverage is a home run. After signing up, seniors receive affordable access to some of the most advanced medications available. They'll be healthier and more stable financially.

First implemented in 2006, Part D has exceeded all expectations. In its first year, almost 11 million seniors gained comprehensive prescription drug coverage. Today more than 40 million people are Part D beneficiaries and they like it. Nine in ten older adults enrolled reported they were satisfied with their coverage.

And according to the Congressional Budget Office, total Part D costs were 45 percent less than originally predicted. Premiums have remained remarkably steady from year to year.

Part D is also about prevention and promoting better health. One study showed an 8 percent decrease in hospital admissions among seniors with Part D coverage.

Older adults also can be confident that they'll find a prescription drug plan that matches their individual needs. In 2017, Part D will boast 746 different plans across 34 regions of the country.

Despite all of these benefits, some policymakers think the drugs covered under Part D cost too much. They point to examples of other organizations, such as the Department of Veterans Affairs, which have secured "lower prices."

That comparison is misinformed. The VA National Formulary maintains low prices by excluding critical new medications from coverage. Only 19 percent of the drugs approved by the FDA since 2000 were covered as of 2005. The vast majority of currently covered drugs are older and potentially less effective than the drugs used throughout the rest of the American health care system. Of the top 200 Part D drugs, the VA covers just more than 80 percent. By comparison, the two highest-enrollment Part D plans cover nearly 96 percent.

Far from offering a better model, the VA is keeping costs down by restricting access to care. Allowing lawmakers to remodel Part D after the VA would be a disaster; a better idea would be to reform the VA plan to mirror Part D.

Unlike the lasting celebration of winning a World Series, the Medicare open enrollment period won't stay open much longer, so older Americans shouldn't delay shopping for a drug plan that provides them with affordable, quality medications.

(Bob Blancato is the executive director of the nonprofit National Association of Nutrition and Aging Services Programs, www.nanasp.org.)

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