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Adverse Selection in Retiree Prescription Drug Plans

In: Frontiers in Health Policy Research, Volume 9

Author

Listed:
  • Dana P. Goldman
  • Geoffrey Joyce
  • Pinar Karaca-Mandic
  • Neeraj Sood

Abstract

We used claims data from a large U.S. employer that introduced changes in its medical and drug coverage offerings in 2002 for non-Medicare eligible retirees. In addition to the existing plans, the employer introduced two new plans in 2002 that were less generous both in terms of medical and drug coverage. Further, one of the new plans had an annual benefit limit of $2,500 on prescription drugs, similar to the "doughnut hole" in the standard Medicare Part D benefit. We examined beneficiaries switching behavior in response to the new choice set and estimated the independent effects of medical and drug benefits on plan selection. We found that beneficiaries in better health were more likely to switch to the new, less generous plans. While the generosity of the medical benefit played a more important role in choosing a plan, choices did not vary significantly by health status. In contrast, sicker individuals were more likely to enroll in plans with generous drug benefits. This suggests that drug coverage may be more susceptible to adverse selection than medical insurance.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Dana P. Goldman & Geoffrey Joyce & Pinar Karaca-Mandic & Neeraj Sood, 2006. "Adverse Selection in Retiree Prescription Drug Plans," NBER Chapters, in: Frontiers in Health Policy Research, Volume 9, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberch:9881
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    Cited by:

    1. Carey, Colleen, 2021. "Sharing the burden of subsidization: Evidence on pass-through from a subsidy revision in Medicare Part D," Journal of Public Economics, Elsevier, vol. 198(C).
    2. Colleen Carey, 2017. "Technological Change and Risk Adjustment: Benefit Design Incentives in Medicare Part D," American Economic Journal: Economic Policy, American Economic Association, vol. 9(1), pages 38-73, February.
    3. Munkin M & Trivedi P. K, 2009. "Incentives and Selection Effects of Drug Coverage on Total Drug Expenditure: a Finite Mixture Approach," Health, Econometrics and Data Group (HEDG) Working Papers 09/22, HEDG, c/o Department of Economics, University of York.
    4. Murat K. Munkin & Pravin K. Trivedi, 2010. "Disentangling incentives effects of insurance coverage from adverse selection in the case of drug expenditure: a finite mixture approach," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1093-1108, September.

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