Medicare Drug Law Hurts Frail Seniors

The nation's leading assisted living association is urging Congress to provide relief from drug co-payments for more than 100,000 poor seniors who live in assisted living communities.

"More and more, seniors are looking to assisted living as their preferred senior housing option," said Richard Grimes, the President and CEO of the Assisted Living Federation of America, the trade association for professionally managed assisted living providers. "The Medicare Modernization Act now effectively punishes income eligible seniors who choose assisted living, a community based alternative to nursing homes."

The 2003 law creating the prescription drug benefit exempts Medicaid and Medicare recipients who live in nursing homes from co-payments. But it does not eliminate co-payments for the same category of seniors who live in assisted living communities. For these impoverished seniors, so-called dual eligible because they qualify for both Medicare and Medicaid, the cost of drug co-payments is often greater than their personal needs allowance of about $60 a month.

In written testimony submitted to the Senate Special Committee on Aging, Grimes said studies show that residents of nursing homes and assisted living use a similar number of prescriptions -- between 8 and 10. Co-payments for drugs of as little as $1 to $5 can impose an enormous financial hardship on income eligible seniors in assisted living he said. Providing relief to these seniors is a 2008 ALFA priority.

He said that this oversight could force poor assisted living residents into nursing homes which cost on average twice as much. More than 40 states and the District of Columbia have sought waivers from the federal government to use Medicaid dollars for assisted living services for seniors as a cost-effective option.

Assisted living is the fastest growing long term care option in the United States and provides assistance to seniors who need some help in the activities of daily life such as bathing and cooking.