title: The Medicare Part D coverage gap: implications for non-dually eligible older adults with a mental illness.
abstract: This study examines how the Medicare Part D coverage gap impacts non-dually eligible older adults with a mental illness. Qualitative, semistructured interviews were conducted with 11 case managers from community-based agencies serving persons, age 55 and over, with a mental disorder. Five themes illustrating the central difficulties associated with the Part D gap emerged: medication affordability, beneficiary understanding, administrative barriers, Low-Income Subsidy income and asset guidelines, and medication compliance. Although the Patient Protection and Affordable Care Act gradually reduces cost sharing within the gap, findings suggest that medication access and adherence may continue to be impacted by the benefit's structure.
authors.affiliation: a School of Social Work , University at Buffalo, The State University of New York , Buffalo , New York , USA.
authors.forename: Louanne
authors.initials: L
authors.lastname: Bakk
authors.forename: Amanda Toler
authors.initials: AT
authors.lastname: Woodward
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Dunkle
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D019090:Case Management; D002908:Chronic Disease; D015897:Comorbidity; D017281:Cost of Illness; D004608:Eligibility Determination / Q000191:economics* / Q000331:legislation & jurisprudence; D005260:Female; D005102:Health Expenditures / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000191:economics / Q000331:legislation & jurisprudence; D007407:Interviews as Topic; D008484:Medicaid / Q000191:economics* / Q000331:legislation & jurisprudence; D054524:Medicare Part D / Q000191:economics* / Q000331:legislation & jurisprudence; D001523:Mental Disorders / Q000188:drug therapy / Q000191:economics*; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act / Q000191:economics / Q000592:standards; D011619:Psychotropic Drugs / Q000191:economics* / Q000627:therapeutic use; D036301:Qualitative Research; D014481:United States; D016903:Drug Monitoring
chemical_list: D011619:Psychotropic Drugs