Prescription for Change

Both candidates say they would help cover the cost of prescription drugs for the 39 million elderly and disabled Americans who participate in Medicare. But they would take quite different approaches: George W. Bush proposes a complete restructuring of Medicare that would give private insurers and health care providers a greater role in determining benefits. Al Gore would add limited drug coverage to the existing government-run Medicare system.

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MEDICARE

BASIC DRUG COVERAGE

GEORGE W. BUSH

Not yet determined, but campaign officials estimate plan would cover an average of $800 in annual drug expenses for each beneficiary.

AL GORE

Medicare would pay 50% of prescription expenses, subject to caps: Government share limited to $1,000 in first year of program, rising to $2,500 after 10 years.

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OUT-OF-POCKET SPENDING CAPS

GEORGE W. BUSH

Plan would cover all medical expenses, including drugs, above $6,000 per year.

AL GORE

Plan would cover all prescription drug expenses exceeding $4,000 per year.

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ANNUAL PREMIUMS

GEORGE W. BUSH

Premiums would be determined by each private insurer and HMO. The government would contribute a fixed amount for each beneficiary, equal to 25% of the average annual premium for all drug plans.

AL GORE

Beneficiaries would pay premiums of $350 a year initially, rising to $540 when plan is fully phased-in. Government would pay 50% of the cost of coverage.

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CO-PAYS AND DEDUCTIBLES

GEORGE W. BUSH

The amounts beneficiaries pay out of pocket would be determined by each participating insurer and HMO.

AL GORE

Beneficiaries would pay 50% of the cost of each prescription.

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ENROLLMENT

GEORGE W. BUSH

Beneficiaries could switch plans once a year. They could go without drug coverage initially but later sign up for a plan that provides it.

AL GORE

Beneficiaries would have one opportunity to sign up for drug coverage when they reach the age of 65. After that, they could obtain drug coverage only if dropped from their HMO or retiree drug plan.

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LOW-INCOME SUBSIDIES

GEORGE W. BUSH

Government would cover co-pays and premiums for all health costs, including prescription drugs, for individuals with incomes below $11,300 and couples below $15,000. The subsidies would phase out at income levels of $14,590 for individuals and $19,680 for couples.

AL GORE

Same as Bush plan, except the subsidies would phase out at income levels of $12,525 for individuals and $16,875 for couples.

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Source: Bush and Gore campaigns