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'This is Your Government on Drugs'; Medicare Drug Benefit 'Meltdown' Outlined at Free Clinic

Posted on: Friday, 13 January 2006, 00:00 CST

By Morgan Kelly

mkelly@wvgazette.com

Some West Virginia seniors say the Medicare prescription drug program that began Jan. 1 has so far failed to help them get the drugs they need.

At a Wednesday press conference hosted by free-clinic West Virginia Health Right Inc., people in the federal program said the drugs aren't as cheap as they were promised, the drugs they need aren't offered and they haven't received their benefit cards after signing up for a plan.

The new program allows Medicare recipients to buy their medicine through plans offered by private insurance companies. Beneficiaries choose plans based on what they can afford and the drugs they need. Medicare will help pay part of the drug costs.

Since the plans come from insurance companies, people on Medicare must pay a premium, deductible and co-pay. Beneficiaries such as Harold Loudin of Nitro applied for a low-income subsidy through Social Security, which would dramatically reduce drug costs.

But when Loudin went to the drug store, what was supposed to be a $10 tab turned out to be $144. Although he got a letter confirming his Social Security subsidy, it had not been applied to his drug plan. Furthermore, he received a $35 boost in his Social Security check, but began losing $89 each month to cover the premium for Medicare parts A and B.

"I'm worse [off] now than what I was. If you're a senior citizen, you're through," the 66-year-old said. "You can't get help from the government. All they're doing is hurting people. I think they had it planned from the get-go."

Loudin's problem is widespread, said Pat White, Health Right's administrator. Missteps have plagued the Medicare drug benefit since it began Jan. 1.

Health Right helps seniors enroll in drug plans and fills prescriptions for those whose plans don't work, White said. The clinic has signed up 400 of the 4,000 seniors who come there for free medicine.

"We haven't been able to get [Medicare] to work for a single patient. It's almost comical if it wasn't so sad," White said. "This is your government on drugs. This is what they came up with."

Neither the government nor the insurance companies will take responsibility for the "system meltdown," she said. They blame each other, government agencies with seemingly nothing to do with Medicare and even seniors, she said.

In the end, poor seniors foot the bill for expensive drugs they got for free before the Medicare plans began, White said. (Pharmaceutical companies will stop sending drugs to free clinics such as Health Right in May, when enrollment in the Medicare drug plans ends.)

"They call it a benefit, but it's not," White said. "The federal government took a system that was working and they broke it. [Medicare] is a disaster for poor people."

The majority of people having a problem with the new benefit are those belonging to Medicare and Medicaid, the federal health program for the poor, said Lorraine Ryan, a spokeswoman for the Centers for Medicare and Medicaid Services. CMS directs both programs.

CMS recently began helping insurance companies go through their files and make sure that the hundreds of thousands of poor people such as Loudin who should get the low-income subsidy actually get it, she said. This process should be done in a matter of days, she said.

Although the number of people having a problem getting their medicine through Medicare is small, "It is unacceptable for beneficiaries to not receive their prescriptions," Ryan said. "We recognize that this is a vulnerable population."

Some seniors are afraid they will have to choose between food and medicine, said Jackie Conley, a health educator at Health Right handling Medicare questions.

It's been weeks since Barbara McDerment, 69, of Sissonville, joined a plan. Her application has yet to be processed. Since she did not sign up before Jan. 1, she must wait at least until Feb. 1 for her prescription plan to take effect. But she fears it may be weeks later before she can start buying her medicine.

"It's going to kill me with worry," said McDerment, who's been getting her medication from Health Right in two-week doses. "It's upsetting."

Medicare beneficiaries had until Jan. 1 to sign onto a plan. After that, they must wait until the first day of the month after they sign up. West Virginians can choose from about 60 plans until May 2006. After May, people will pay extra for signing up late.

Each plan offers different drugs and different prices. Monthly premiums range from $10 to $60. Medicare beneficiaries were expected to shell out $250 each year for medication before Medicare took over; some plans have eliminated that.

The bevy of advertisements and marketing phone calls only confuse seniors, White said. "They think all the plans are the same and they aren't."

Greg Hodges, 58, still can't find a plan that will cover all of the $1,000 in medicine he takes each month. Many of his drugs are expensive and don't have generic counterparts, the Midway resident said. If a plan doesn't cover a certain drug, he'll have to pay for it.

"I'm afraid to sign up for a plan," he said.

Sherri Kessel, of Clendenin, and her family pick up the tab for her father's medication because the drug card he signed up for never arrived, she said.

"It's hurting so many people," Kessel said. "It takes everything we make to make it. It's wrong the way we're doing the elderly people."

Meanwhile on Tuesday, Gov. Joe Manchin took part in a ribbon- cutting ceremony for a state Bureau of Senior Services' call center to help with Medicare problems. The number is (877) 987-4463.

To contact staff writer Morgan Kelly, use e-mail or call 348- 1254.

Source: Charleston Gazette, The

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