Patient Experiences in Selecting a Medicare Part D Prescription Drug Plan

Authors

Cheryl D. Stults, Palo Alto Medical Foundation Research InstituteFollow
Alison Baskin, National Institutes of HealthFollow
Ming Tai-Seale, Palo Alto Medical Foundation Research Institute
M. Kate Bundorf, Stanford UniversityFollow

Publication Date

8-15-2016

Keywords

qualitative research, Medicare Part D

Abstract

Background/Aims: To obtain publicly subsidized prescription drug insurance, Medicare beneficiaries must enroll in one of the 28–39 private plans offered by their state. We sought to understand the experiences of individuals selecting a Part D plan, specifically what resources and which factors were of greatest importance to them.

Methods: Participants were patients of a large multispecialty group practice in northern California. Potential participants were recruited through flyers, several events for seniors and an article in the group practice’s newsletter. Four focus groups were conducted from June through October 2014 until thematic saturation was reached. The 17 participants were all in a Medicare Part D plan, with ages ranging from 65 to 91 years (average of 74), primarily wealthy, retired and Caucasian. Focus groups were transcribed and qualitatively analyzed for main emergent themes.

Results: Most found the process of selecting a plan to be a “nightmare” to “extremely difficult” and “confusing” due to “too many options.” Participants expressed that the characteristic of most importance to them in choosing a plan was the lowest cost, mainly through lower copays for medicines. Another important feature was the reputation of the company providing the plan to learn if “they make mistakes often,” “handle claims satisfactorily,” and “can you reach somebody if you need to.” The main resources used in the decision-making process were other people (e.g. spouse, friend, family), books, brokers, AARP, the Health Insurance Counseling and Advocacy Program –– a volunteer-supported program run by the California Department of Aging that provides unbiased information to help Medicare beneficiaries make the best choices for their individual health care needs –– and the Internet, specifically the Medicare.gov website.

Conclusion: While low cost was a top priority for some, other participants reported that other characteristics like reputation of the company was so important to them that they were willing to pay a higher cost. More help from individuals and clearer information are necessary to assist Medicare beneficiaries in selecting a Medicare Part D prescription drug plan. Given that highly educated and affluent Medicare beneficiaries are finding the Part D plan selection process so difficult and complex, this poses a greater challenge for those with fewer resources.

Recommended Citation

Stults CD, Baskin A, Tai-Seale M, Bundorf MK. Patient experiences in selecting a Medicare Part D prescription drug plan. J Patient Cent Res Rev. 2016;3:207.