Understanding the coverage decisions of Medicare beneficiaries: An analysis of enrollment and beneficiary knowledge

Objectives. To examine individual and market characteristics in relation to Medicare beneficiaries' prescription drug enrollment decisions and understanding of the Part D Program in early 2006.;Methodology. Data sources included the 2005 Medicare Current Beneficiary Survey and linked files describing sources of creditable prescription drug coverage, Part D enrollment, and features of Part D plan markets. The study sample consisted of approximately 12,000 (estimated 31.5 million) self-responding, community-dwelling beneficiaries who were continuously enrolled throughout 2005.;Primary outcomes were beneficiary Part D plan enrollment at the 2006 enrollment deadline (Aim 1; Chapter 4) and beneficiary knowledge of the Part D Program (Aim 2; Chapter 5). Frequency tabulations, stratified analyses, and multivariate regression models were used to assess whether and to what extent beneficiary and market characteristics were associated with these outcomes.;Results. An estimated 4.9 million (15.7%) beneficiaries remained without a known source of creditable drug coverage after the Part D enrollment deadline, 12.2 million (39.0%) self-enrolled into a Part D plan, 3.9 million (12.5%) were auto-enrolled in a Part D plan, and 10.3 million (32.8%) retained prescription coverage from other sources. Among beneficiaries with a salient Part D enrollment decision, 28.6% did not enroll. Beneficiaries who were under the age of 65, over the age of 85, with incomes above ;Conclusions. Beneficiaries with strong incentives to gain prescription drug coverage were both more likely to learn more about the Medicare Program and more likely to ultimately enroll in a Part D plan. Educating beneficiaries, especially those who may not yet recognize the need, about the importance of obtaining drug coverage remains a priority.