Variance in Medicare pharmacy benefits is wide

MANAGED CARE October 1999. ©1999 MediMedia USA

As Congress wrestles with Medicare prescription-drug coverage, HMOs are considering how such a mandate would affect Medicare HMOs' ability to compete for fee-for-service enrollees. A Barents Group study of HCFA data, current as of May, notes that 83 percent of Medicare HMOs' basic plans offer a prescription benefit — perhaps Medicare HMOs' most powerful lure — with widely varying coverage and copayments. The days of zero-copayments are waning, though; all Medicare HMOs will institute some kind of copayment in 2000.

SOURCE: ANALYSIS OF BENEFITS OFFERED BY MEDICARE HMOs: COMPLEXITIES AND IMPLICATIONS, THE KAISER FAMILY FOUNDATION, MENLO PARK, CALIF., 1999