Health insurers—frustrated by lower reimbursement rates for the low-income segment of Medicare Part D recipients—have started increasing premiums. That is forcing recipients to look for other prescription drug plans elsewhere, according to a study published in the journal Health Affairs. 

Often these lower-income seniors have multiple conditions and need more medications than they can afford to stay on with Part D. When Medicare Part D was put in place, the hope was that competition between private plans would lead to lowered premiums. This hasn’t happened, the authors of the study said. 

Possible fixes include increasing subsidies for insurers willing to cover low-income patients and altering risk adjustment approaches, such as including information about a patient’s medication history, UPI reported.