Christensen S
Congressional Budget Office, U.S. Congress, Washington, DC 20515.
Inquiry. 1992 Winter;29(4):426-39.
Medicare enrollees are at risk for potentially unlimited out-of-pocket costs for acute care, defined here as prescription drug costs and copayments on covered services. As a result, many enrollees supplement Medicare with Medigap insurance, which increases their premium costs and their use of Medicare-covered services. The objective of this study was to limit enrollees' risk for acute care costs without increasing federal spending. The study found that savings from prohibiting Medigap would be sufficient to provide a copayment cap under Medicare. If Medicare's copayment requirements were also restructured, the savings would finance a prescription drug benefit as well. Most enrollees could expect lower expenses for premiums and out-of-pocket costs combined, but expenses would be significantly higher for 5% of enrollees, all current Medigap policyholders.
医疗保险参保人面临急性护理方面可能无限的自付费用风险，在此定义为处方药费用和涵盖服务的共付额。因此，许多参保人通过购买医疗补助保险来补充医疗保险，这增加了他们的保费成本以及对医疗保险涵盖服务的使用。本研究的目的是在不增加联邦支出的情况下，限制参保人急性护理费用的风险。研究发现，禁止医疗补助保险所节省的资金足以在医疗保险下设定共付额上限。如果医疗保险的共付要求也进行调整，节省的资金还可为处方药福利提供资金。大多数参保人预计保费和自付费用的总和会降低，但对于5%的参保人（即所有当前的医疗补助保险投保人）来说，费用会显著更高。
