Prescription drug coverage became available under Medicare for the first time in 2006 under Medicare Part D--the most significant change in government health care programs in 40 years. While it offers the potential for improved access to needed medications for millions of Americans, Part D has had both successes and challenges. With the program now in its second year, researchers have the opportunity to learn from experiences and strengthen the program, particularly as it affects the frailest, sickest, and most vulnerable beneficiaries. Although 13.2 million beneficiaries are eligible for a low-income subsidy to help pay for premiums and medication copayments, 3.3 million of this group are not enrolled in Part D and not receiving the subsidy. This report discusses some of the challenges vulnerable Medicare beneficiaries face in using Part D and makes specific recommendations, like using simpler, more standard procedures and ensuring that needed counseling support is provided.
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