Prescription Drug Coverage and California Seniors -- California Capitol Hill Bulletin -- Volume 10, Bulletin 1 -- January 9, 2003

Eighteen percent of seniors in California report either not filling a prescription due to cost or skipping doses to make their medicine last longer, according to a new survey released on October 31, 2002 by the Henry J. Kaiser Family Foundation. The rates are even higher for seniors with incomes below the poverty line (28%) and those with three or more chronic health conditions (26%).

The study found differences with respect to prescription drug coverage for seniors in California. Though the majority of those surveyed had some form of prescription drug coverage, 18 percent indicated that they had no insurance to help pay the cost. Of those who have such coverage, 30 percent are covered by Medicare+Choice, which constitutes a primary source of coverage in the state, and 30 percent are covered by employer plans. A majority of those seniors (56%) with low incomes, which include high rates of Black, Hispanic, and Asian/Pacific Islander seniors, and 24% of near-poor seniors, received coverage under Medi-Cal, although more than four in ten seniors with incomes below the poverty level did not get drug coverage under Medi-Cal.

The authors also note variations in financial protections for the state's senior citizens. Sixteen percent report spending $100 or more per-month on out-of-pocket prescription drugs, while 27% of seniors with three or more chronic conditions and 22% of those aged 85 and older indicate similar expenditures. Seniors covered by Medigap are less fortunate than their counterparts, since 28% of Medigap recipients paid $100 or more per month for medication while one in ten seniors with drug coverage under Medicare+Choice, Medi-Cal, or employer plans did the same. Further variation is noted between those seniors with and without prescription drug coverage; in comparison with 11% of seniors with coverage, 40% of those without coverage spend $100 or more per month on their medications.

Despite high rates of seniors with out-of-pocket expenses on prescription drugs, the study found that the majority of California's seniors were not aware of the California Prescription Drug Discount, which offers help to Medicare recipients with their prescription drug expenditures. Less than a quarter of all of the state's seniors said they had heard about the program, and one-third of those familiar with the program have actually utilized it.

The study concludes that seniors without coverage or who have inadequate drug coverage are vulnerable to high out-of-pocket expenditures, and risk going without medication due to cost. Its findings are based on a survey of seniors in eight states conducted in 2001. For more information, please visit The Kaiser Family Foundation's website at http://www.kff.org .

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