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Seniors Seek Medicare Help

Posted on: Friday, 4 November 2005, 03:00 CST

By Jeff Sturgeon jeff.sturgeon@roanoke.com 981-3251

You're on Medicare, take multiple prescriptions and know that studying the Medicare drug plans is a must. Eager to save money but confused how to proceed, you seek a prompt appointment at the League of Older Americans to talk with an insurance counselor but are told the wait could be days.

How about the pharmacist? An insurance agent? Your doctor? Can they help?

The answer, it seems, is maybe. Sort of. But not really.

You may be on your own, for the time being. Seniors have many weeks left to make a decision. But for those who are trying to learn about Medicare Part D, the lack of reliable help can be frustrating.

According to health insurance counselors from Fairfax to Roanoke, the people who answer the phones at 1-800-MEDICARE are redirecting callers. The federal government has repeatedly said the phone number is staffed with trained personnel to help citizens. It hasn't worked out that way, even as the opening of the enrollment period, Nov. 15, approaches.

Concern over the practice of redirecting callers has reached the highest levels of Virginia government with no clear resolution yet in sight.

"Our understanding was that hotline staff would assist these folks rather than simply refer them to someone else," Pat Finnerty, the director of Virginia's Medicaid program, wrote in an e-mail to a Medicare representative.

Finnerty's Oct. 20 e-mail, released Tuesday by the Virginia Department of Aging, said community-based insurance counselors associated with the Virginia Insurance Counseling and Assistance Program, to whom Medicare is referring callers, "have no additional staff to handle this influx of calls."

One insurance counselor, Shannon Abell, director of senior resources at the League of Older Americans in Roanoke, said Wednesday he had just spoken to a client who'd reached him after a fruitless attempt to get information from Medicare. Medicare had sent the client to the Virginia Department of Aging, which then told the caller to contact Abell.

"It's three calls to get to me to be able to say, 'I can't help you right now. We'll put you on the waiting list,' " Abell said.

Abell has described his workload as virtually impossible. His service area is home to 62,000 persons 60 or older. He doesn't know how many are at least 65, the age of Medicare eligibility, but it's a safe bet there are tens of thousands. He has a part-time assistant and five or six volunteers who are available a couple of hours a week. The team receives about 35 calls a week, many from people who need an hour or more of guidance.

So what's a senior to do?

Walk into most any pharmacy. Many, including both chain locations and independents, are offering literature to simplify the process of choosing a Medicare drug plan. "Let's talk," says a Wal-Mart brochure. Walgreens makes available its branded "Show-Me Guide" to explain the complex new benefit, for which enrollment begins Nov. 15. "Medicap Pharmacy is here to help," says a pamphlet available at the Brambleton Medicap in Roanoke County.

One Roanoke Valley advertising executive sees a potential business motive in such red-carpet treatment directed at a consumer group that's often described as "fixed-income."

By offering free details about a topic as vital as Medicare Part D, a pharmacy creates a natural draw for seniors, said John Anstey of the Anstey Advertising Group in Roanoke.

"Customers are always looking for information and if someone can position themselves as being able to answer all of someone's questions, then it can be a great marketing," he said.

So, should you rely on the same people who supply your drugs for guidance on which prescription plan to buy, too?

Medicare said pharmacists can help. It is against regulations for a pharmacist to steer a patient to a particular plan. But otherwise, Medicare spokeswoman Lorraine Ryan said, patients can receive meaningful help from pharmacy workers

!-- 2013(unknown) --> as long as the workers have time. "We estimate it will take about an hour to an hour and a half to fully evaluate the options for a patient that's just taking an average number of prescriptions," said Rebecca Snead, who directs the Virginia Pharmacists Association.

So, can insurance agents provide meaningful advice about selecting a drug plan?

Hal Peters, owner of Ferrum Financial and Insurance Services, in Ferrum, said he is available. "My job is to help people get the right plan at the right price," Peters said. He said the service is free to the client; the agent is paid on a commission.

One word of caution comes from Vicki Gottlich, a senior policy attorney at the Center for Medicare Advocacy. She recommended taking advice only from insurance agents who are certified to represent the drug plans of at least two of the 18 insurance companies with offerings on the market in Virginia. The more, the better, she said.

In addition, Gottlich warned that seniors should be wary of any adviser whose come-on goes anything like this: "You pay me. I'll choose the best plan for you." There is no need to pay for help, she said.

So, can doctors help the senior who merely wants to take advantage of the promised new savings on prescriptions? Probably not.

Hugh Thornhill is president of Carilion Medical Group, which consists of about 65 physician practices that see 1,250 Medicare- age patients daily.

Thornhill said he's determined that the Carilion doctors lack the time and knowledge to provide meaningful personal guidance to patients. Impartiality requirements limit what doctors can say anyway, he said.

Medicare has predicted that, by Nov. 15, 9,000 operators will be hired to staff phone banks. Only those callers who wish to talk to someone in their hometown will be re-referred to organization's like Abell's, the agency said.

Staff writer Lois Caliri contributed to this report.

Source: Roanoke Times & World News

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