Hispanics seniors need to take advantage of this health benefit NOW

Hispanic seniors are 35 percent less likely to have prescription drug coverage despite the fact they are often eligible for the Medicare Prescription Drug Plan (Part D) and the availability of assistance to help pay insurance premiums through government programs.

According to a new study in the journal Health Affairs this month, the disparity seen among Hispanics eligible for prescription drug assistance is likely due to health and financial literacy issues, meaning that even when language itself isn’t a barrier, assistance plans aren’t clear and neither are the medical conditions they offer coverage for.

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“These results indicate that disparities in prescription drug coverage exist between Hispanic and white Medicare beneficiaries, despite the existence of a potentially universal entitlement program,” said Brian McGarry, a graduate student in the Department of Public Health Sciences, as reported by RedOrbit. “This study suggests that, in spite of the overall success of the Part D program, future policies need to focus on the disproportionately low enrollment of vulnerable populations.”

According to the Medicare website, Part D was implemented in 2006 as a way to offer people of all ages and races/ethnicities a means to gain access to needed medications at discounted rates. Though the drug coverage plan’s benefits depend on what type of primary insurance it is tacked onto, most people over the age of 65 on Medicare will be required to select a prescription drug plan or face a financial penalty.

But, as beneficial as the Medicare Prescription Drug Plan is to seniors, it’s not very straightforward. For example, seniors who have both Medicaid and Medicare automatically have Part D, but those who only have Medicare must sign up for coverage through a separate process and if they don’t meet enrollment deadlines, financial penalties are slowly increased. What prescriptions you need and where you live can also determine what type of Prescription Drug Plan you can sign up for.

“Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different “tiers” on their formularies. Drugs in each tier have a different cost,” explains Medicare in the most basic breakdown of how Part D works. “A drug in a lower tier will generally cost you less than a drug in a higher tier. In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower copayment.”

Because the process isn’t streamlined and can be confusing for anyone, those who speak English as a second language or whose families have only been in the United States for a short amount of time are at an even greater disadvantage.

Data for the new study was pulled from the National Health and Aging Trends Study, a highly detailed source of data about Medicare beneficiaries. When looked at for Plan D eligibility and participation, the study indicated that Hispanic seniors were 35 percent less likely than non-Hispanic whites to have any form of drug coverage regardless of demand for prescription drugs and ability to afford a plan. The lack of drug coverage participation is concerning, given the fact approximately 65 percent of Hispanics without coverage are eligible to receive premium support.

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Researchers feel that it is not a lack of Spanish-language materials on Plan D that accounts for the disparity, but more likely a lack of outreach programs that could assist Hispanic seniors who need to enroll in a drug plan. Similar thoughts have been voiced regarding the lack of Hispanic enrollment in the Affordable Care Act programs, and experts are now working on effective methods to help the Hispanic community maximize their health coverage potential.