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Medicare Drug Benefit Letters Due

Posted on: Sunday, 14 August 2005, 12:00 CDT

Aug. 14--Senior citizens eligible for Medicare will soon be bombarded with letters and advertisements. It's all because of the new Medicare drug benefit, which takes effect Jan. 1, 2006.

Those who ignore the information, or make bad choices, could pay dearly.

One of the most important dates is Nov. 15. That's when seniors can begin signing up for the drug benefit, called Medicare Part D. But the letters and promotions will begin well before then.

It's especially important not to ignore letters from the Centers for Medicare and Medicaid Services or the Social Security Administration.

For example, the Social Security Administration already is contacting the poorest Medicare recipients, who can obtain prescription drugs for as little as $2 per prescription.

During a presentation at Mechanicsburg Area Senior Center last week, Michelle Sundy of the Cumberland County Office of Aging urged those who receive the forms not to ignore them.

"When it doubt, fill it out -- that's what we're telling people," she said.

But Sundy also warned of scammers who might call by phone and ask for personal financial information such as bank account information.

If the call sounds legitimate, ask for an application form to be sent in the mail, she said. If it sounds fishy, contact the office of aging in your county, she said.

People who have a prescription-drug plan through a former employer or union also should be on the lookout for a letter. This letter will tell them if their present drug benefit is "at least as good" as Part D.

If it's not, the government wants them to sign up for Part D.

Those who fail to sign up before the May 15, 2006, deadline face a penalty when they eventually do enroll.

The penalty is a premium increase of 1 percent per month for each month the person fails to sign up after the May 15 deadline. It applies to anyone without a Part D-equivalent drug plan who doesn't sign up for Part D.

Someone who waits two years to sign up, for example, would pay a monthly premium that's 24 percent higher than if they would have signed up during the original enrollment period.

There are two basic ways to get Part D. Seniors can keep regular Medicare and enroll with a private insurer for Part D. Or they can leave traditional Medicare for a Medicare managed-care plan, also known as a Medicare Advantage plan, that will include Part D.

Unfortunately, the details of those plans won't be known until after Oct. 1, when the government will permit the insurers to begin marketing their offerings.

Some of the plans will come from familiar names such as Capital Blue Cross, Highmark Blue Shield and HealthAmerica. Insurers from outside the area also will be vying to sign up local seniors.

The drug benefits can vary among plans, but each plan must meet minimum standards set by Medicare. The government hopes that competition among health insurers will drive down costs.

Everyone who is eligible for Medicare is eligible for Part D coverage. Still, Pennsylvania's two highly regarded prescription plans for seniors -- PACE and PACENET -- will remain available and may be the best choice for some seniors.

Last week, Sundy told seniors that Part D is confusing and makes some seniors want to put their heads in the sand.

"A lot of people just kind of look the other way and say' I don't need it,'¤" she said.

But Sundy and other advocates stress that seniors must make the effort to inform themselves. They should realize it will take a while to absorb the details.

Advocates such as Sundy will be spending the rest of the year, and beyond, meeting with people at senior centers, schools and public libraries to discuss the benefits.

Cosma Madigan of Lower Allen Twp. is well aware of how imposing Part D can be. The 78-year-old widow recently received a letter from her longtime insurer. The insurer said it was ending her drug coverage, and she must sign up for Part D.

She's been a member of the health plan since her late husband retired from the railroad 18 years ago, and she pays $345 a month. She has asthma and other ailments and requires prescriptions that cost several hundred dollars every month. She worries that she'll spend more for drugs under Part D.

Madigan is active, taking computer classes at a senior center and volunteering at a nursing home.

Although the new drug plans that will become available in October might provide better options, Madigan has no desire to research all the choices, or to move away from a plan that has met her needs for 18 years. She's angry at the government for making her do so.

"How can they do that? That's what I want to know," she said. "At 78 years old, I'm afraid to make a change. I really am."

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Source: The Patriot-News

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