Figure 1. Issues Related to Auto-Enrollment (Percent of Respondents Reporting How Often Issues Occur)

8%

22%

16%

12%

20%

38%

38%

42%

48%

14%

25%

22%

21%

15%

15%

19%

11%

6%

5%

3%Beneficiaries are auto-enrolled to plans thatdo not contract with pharmacies near their

homes

Auto-enrollment occurs, but the pharmacyhas no record of the plan assignment

Beneficiaries are enrolled in more than oneplan

Medicaid beneficiaries who become eligiblefor Medicare are not auto-enrolled in a plan,

and therefore have no prescription drugcoverage

Very often Often Sometimes Rarely or never Unsure or don't know

N=641.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

Figure 2. Incorrect Charges Associated with Auto-Enrollment(Percent of Respondents Reporting How Often Issues Occur)

20% 21%

41% 41%

16%

17% 19%

8%6%

11%

0%

50%

100%

Beneficiaries who receive the LIS arebilled for premium payments (althoughthey are not reqired to pay premiums).

Beneficiaries who receive the LIS aretold at the pharmacy that they must pay

amounts for drugs that exceed theminimal copayment they should be

charged.

Very often Often Sometimes Rarely or never Unsure or don't know

N=505.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

Figure 3. Resolving Issues Related to Auto-Enrollment(Percent of Respondents Reporting on Average Time Required to Resolve Issues)

32%

59%

50%

14%

15%

27%

20%

27%

19%

16%

13% 9%

0% 50% 100%

Beneficiaries are enrolled in more than oneplan

Auto-enrollment occurs, but the pharmacyhas no record of the plan assignment

Medicaid beneficiaries who become eligiblefor Medicare are not auto-enrolled in a plan,

and therefore have no prescription drugcoverage

< 2 weeks 2 weeks to 1 month 1 month or more Frequently unresolved

N=Number of respondents who report experience attempting to resolve these issues—279, 301, 273—respectively.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

Figure 4. Difficulties Related to Obtaining Needed Drugs (Percent of Respondents Reporting How Often Issues Occur)

19%

13%

12%

25%

28%

25%

20%

37%

41%

50%

60%

11%

9%

14%

8%

9%

2%

4%

7%6%

Beneficiaries cannot find appropriate plans thatcontract with pharmacies near home

Beneficiaries with multiple drug needs havedifficulty finding plans

Drugs on formulary are subsequently taken off

A needed drug is not on the plan's formulary

Very often Often Sometimes Rarely or never Unsure or don't know

N=562.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

Figure 5. Consequences of Difficulties Related to Procedures to Obtain Drugs

(Percent of Respondents Reporting How Often Consequences Occur)

10% 11%

27% 28%21%

48% 44%48%

40%

22%

15%

15%

32%

21%

41%

8% 8% 2%

16%

2%

8%8%9%8%8%

0%

25%

50%

75%

100%

Must pay out-of-pocket

Delays gettingneeded drugs

Unable to getneeded drugs

Health or well-being

negativelyaffected

More ER orother careneeded

Very often Often Sometimes Rarely or never Unsure or don't know

N=537.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

Figure 6. Average Time Required for Resolving Difficulties Related to Utilization Management Rules

(Percent of Respondents Reporting on Average Time to Resolve Issues)

39%

14%

18%

29%

0%

50%

100%

< 2 weeks 2 weeks to 1 month 1 month or more Frequently unresolved

N=271 respondents who report experience attempting to resolve this issue.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

0%

26%

46%

8%

20%

Figure 7. Issues Related to Obtaining Prescription Drugs (Proportion of Respondents Reporting How Often Events Occur)

1%

45%

15%

29%

10%

Always; almost always Often Sometimes Rarely or never Don't know or unsure

Plans handle coverage determinationsin a timely fashion (72 hours fora standard and 24 hours for an

expedited coverage determination).

N=282, 227 respondents who report experience with these issues. Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

Beneficiaries are able to obtaindrugs in the six protected classes

in a timely manner.

Receiving subsidy and enrolled in a

Part D plan

Eligible but not receiving

LIS and not enrolled

in a Part D planEligible for LIS

5.6(42%)

Deemed eligible for LIS6.9(52%)

Eligible for LIS but have creditable

coverage

3.3*(59%)

2.3(41%)

.7(6%)

Figure 8. Number of Beneficiaries Eligible forand Receiving the Low-Income Subsidy

(in millions)

* Includes 30,000 anticipated facilitated enrollments. Source: Centers for Medicare and Medicaid Services, “Medicare Drug Plans Strong and Growing,” Press Release, Jan. 30, 2007.

Figure 9. Reasons Beneficiaries Do Not Applyfor the Low-Income Subsidy

(Percent of Respondents Reporting that Reasons Are Very Common or Common)

37%

40%

48%

49%

57%

68%

77%

83%

0% 50% 100%

Concerns about estate recovery

Language or literacy difficulties

Reluctant to apply for a "welfare" program

Afraid of losing other "needs-based" benefits

Application process is too complicated

Think they are ineligible for financial reasons

Not aware that a subsidy is available

Do not know how to apply for the subsidy

Note: Other respondents indicated that these reasons were not too common or not at all commonor said they were unsure or didn’t know.N=508.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

Figure 10. Challenges Associated with the Part D Program(Open-ended responses: “Based on your experience, what are the

two biggest challenges in assuring that Part D works well for beneficiaries?”)

ChallengesPercent of Responses

Difficult to get and understand information 23%

Program complexity 17%

Computer system problems 13%

Coverage restrictions 13%

Affordability 11%

Enrollment difficulties 9%

Other* 14%

Note: Respondents could specify up to two challenges.* “Other” includes various challenges, each representing 4% or less of responses.Total responses=717.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

Figure 11. Activities to Help Beneficiaries (Percent of Respondents Reporting How Helpful Activities Are)

26%23% 15%

40%44%

41% 47%

15% 17%26% 24%

13% 16%

2%5%5%11% 11%

11%9%

0%

25%

50%

75%

100%

Information postedon the

MEDICARE.govWeb site

Materials producedby CMS to explain

the Part D plan

Availability of counselors at 1-800-MEDICARE

Materials producedby drug plans to

explain procedures

Unsure or don't knowNot at all helpfulSomewhat helpfulHelpfulVery helpful

N=490.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.

Figure 12. Recommendations for Program Changes(Percent of Respondents Rating the Change

Very Helpful or Helpful for Beneficiaries)

Expand the Point-of-Service system 79%

Extend enrollment periods 78%

Use a standard exceptions process for Part D plans 77%

Eliminate the asset test for the Low-Income Subsidy 73%

Make more information on plan choice available 68%

Make more materials available that are easier for beneficiarieswith limited English proficiency to understand

67%

Increase the number of 1-800-MEDICARE counselors 64%

N=490.Source: Georgetown University Health Policy Institute Survey, Part D and Vulnerable Medicare Beneficiaries, Nov. 2006.