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Seniors, Health Care Officials Tackle Complexities of Medicare

Posted on: Wednesday, 1 February 2006, 21:01 CST

By ANDREA GRIFFITH

The start of the new year marked the start of the federal governments new prescription plan, Medicare Part D, which has caused confusion for many seniors trying to choose one of 38 plans offered in North Carolina.

In the past, only those with a low income have qualified for government assistance in paying for prescription drugs.

Now, everyone with Medicare is eligible to join, regardless of income and resources, health status or current prescription expenses.

Enrollment began in November. After May 15, those signing up will pay a penalty.

Monthly premiums, annual deductibles and co-payments vary among the plans. Part D is adminstered by private insurance companies that decide what drugs to cover and how to share costs with those enrolled.

Don Kerns, a member of the Greater Whitsett Area Ruritan Club, said he has talked to a number of elderly people who are confused about the new plan.

Theyre looking for help in making these personal decisions, Kerns said. Theres a really broad range of different plans.

The Ruritan Club is hosting an information session about the plan on Feb. 7 at the Whitsett Town Hall.

Kerns said that while its great to have a variety, the choices have made the implementation more complicated.

Grace Rumley said that she now pays more money each month for coverage under the new plan, but will save in the long run.

Rumley, site manager for the nutrition program at the Gibsonville Senior Center, was already enrolled in a PARTNERS health plan and decided to stay with the company after reviewing her options. She regularly takes three prescription drugs.

Rumley said that even though staff members from Senior Resources of Guilford and the Social Security Administration presented information at the senior center about the plan in the fall, she was still initially puzzled by the new plan.

The more it was discussed, the more confusing it got, she said.

Rob Cockman, owner of Midtown Pharmacy in Stoney Creek, said the first week of January, when the plan went into effect, was the toughest.

Customers had not been given their new Medicare cards and it was difficult for pharmacists to contact insurance companies to confirm that the customer was enrolled because the companies were inundated with phone calls.

Cockman said because Midtown is locally owned, its employees were able to hold charges to customers until their new cards arrived.

It really hasnt been too bad, Cockman said. Most of the customers have been able to get their card this month.

Michelle Fritsch is the director of AlaMAP, a medication assistance program sponsored by Alamance Regional Medical Center. She said that at the beginning of January, a lot of seniors arrived at pharmacies to pick up prescriptions only to find their enrollment in the new plan had not been fully processed.

The government has since set up a hotline so that pharmacists can call for an update on a patients status.

Its still not perfect, but its a lot better, Fritsch said.

Fritsch said that the hardest part of the new plan is choosing the one thats right for each person. Her staff has been teaching AlaMAPs 1,000 patients to use the demo on the Medicare Web site, which is the only way to find the most cost effective plan, according to Fritsch.

Whats the least expensive method for one person is the most expensive for another one, she said.

Using the demo, seniors can enter the medications they take and find a list of plans that cover those medications, from least expensive to most expensive.

Fritsch said one plan that covers osteoporosis medication costs $2,500 per year, while another costs $35,000 per year -- a big difference thats not spotted easily without using the demo.

For many seniors lacking computer skills, though, using the demo has not been a simple task. Fritsch encourages seniors to ask family members and friends for help.

AlaMAP wants to host an information session in late February at a local school, where people will learn to use the online tool and can sign up for the plan of their choice.

Fritsch said that those enrolling need to remember that their plan becomes effective the first day of the following month. If their plan has not been fully processed by that day, they may have to pay out of pocket and be reimbursed by the insurance company later.By ANDREA GRIFFITH

Staff Writer

Source: Greensboro News Record

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