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HEALTH NEWS

Seniors Face Challenge Figuring Out Medicare Part D

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 06 November, 2005  18:00 GMT

Healthcare companies that have been approved to provide prescription drug benefits to the nation's 43 million Medicare beneficiaries will begin a massive advertising campaign aimed at enrolling seniors in a dizzying array of drug plans.

Called Medicare Part D, the new prescription drug benefit begins Jan. 1 and promises to provide unprecedented assistance with seniors' drug costs.

But seniors can expect an onslaught of cold calls, e-mails and mailings from insurers touting the benefits of their approved plans in the coming weeks. Enrollment begins on Nov. 15.

In California, there will be 47 stand-alone Medicare prescription drug plans for seniors to choose from, according to the federal Centers for Medicare and Medicaid Services, or CMS, which is administering the program.

Another 113 Medicare Advantage plans, mostly offered on a regional basis, also have been approved by CMS to provide prescription drug plans to seniors.

Details on choices offered in each county will be released next week, according to CMS.

"These plan choices are very good news for people with Medicare, especially for those struggling to pay for prescription drugs," said Dr. Mark McClellan, CMS administrator, in a conference call with reporters Friday announcing details on plans offered in each state.

Look at Each Plan's Drug List

Medicare beneficiaries in California who choose a stand-alone drug plan can get coverage for as little as $5.41 per month, McClellan said. But premiums for most plans are in the $20 to $40 range. Beneficiaries should look closely at a number of factors before choosing a plan. For instance, seniors should look at each plan's "drug formulary" or the list of drugs covered to make sure their medications are included.

They should consider their monthly drug costs and whether they will need extra coverage to fill in any gaps. And they should consider convenience, such as whether they can still get their prescriptions filled at their local pharmacy.

"No Medicare beneficiary has to make a decision now," McClellan said. "This is the time to start thinking about Medicare prescription drug coverage."

Some members of Congress and consumer advocates criticized the marketing campaign and prescription drug plan rollout.

"CMS felt compelled to release some details about plan offerings today because tomorrow plans will start bombarding beneficiaries with marketing materials," said Rep. Pete Stark, D-Fremont, a vocal critic of the federal Medicare prescription drug plan, in a statement Friday. "Today's release highlights my overriding concern that Medicare beneficiaries are going to find this array of choices overwhelming."

Don't Give Out Personal Information

California Health Advocates, a consumer group, warned seniors against giving out any personal information over the phone or via e-mail to solicitors.

The plans offering prescription drug benefits are not allowed to ask for personal information such as Social Security numbers, bank account numbers or credit card information.

Plans also must honor verbal requests to not call again, under rules established by CMS.

"This new opportunity for telemarketing is of great concern," said Julie Schoen, director of the California Health Advocates Senior Medicare Patrol Project, which tracks fraud and abuse. "Think of the vulnerable elders who may not understand their options and end up buying something that isn't right for them."

McClellan said seniors will be able to switch plans throughout the open enrollment period of Jan. 1 to May 15, 2006. He also urged seniors already enrolled in Medicare Advantage plans to look for information from their current plan on what's offered.

Mistake Could Result in Loss of Health Coverage

Seniors will need to school themselves on all the fine details when they consider switching to another plan to get prescription drug benefits. For instance, those already enrolled in Medicare Advantage can lose their health benefits by signing up for a stand-alone drug benefit from another company.

Kaiser Permanente is already warning its Medicare Advantage members that signing up for a drug plan offered by another provider could cost them their Kaiser health coverage.

McClellan said that warning will be built into all applications to prevent such mistakes. "Many Medicare Advantage plans in California are offering drug coverage with no additional premium," he said. "We encourage people to stay with their current plans."

For more information on Medicare's new drug coverage, go to http:/ /www.medicare.gov or call (800) MEDICARE. Free, independent and confidential counseling is also available from the Health Insurance Counseling and Advocacy Program at 839-0393.




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Medicare Drug Program Q&A (11 Oct 2005)
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Medicare Drug Plan Costs May Go Up for Many (14 Oct 2006)
It's Medicare Part D Plan Selection Time Again (17 Nov 2008)
 
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