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Drug Plans Working for Most Seniors: Area Medicare Enrolees Describe Their Experiences

Posted on: Sunday, 23 April 2006, 00:00 CDT

By Bob Moos, The Dallas Morning News

Apr. 23--Seniors who've gotten past the anxiety and enrollment glitches have found that Medicare's new drug coverage generally works well for them.

Most are saving money on their prescription medications -- an average of $1,100 a year.

In October, when the drug plans were first marketed, The Dallas Morning News visited several senior households in the area to find out how they would shop for the insurance.

As Medicare's enrollment period heads into its final weeks, we returned to discover whether they're satisfied with the plans they selected.

Robert Young, 65, Plano

Robert Young made a hobby out of searching for drug plans.

A computer enthusiast, he mastered Medicare's interactive Web tool and compared the estimated savings from different insurers. He quickly found that the cheapest plans weren't necessarily the best ones for him and his wife, Jean, 66.

Each spent $3,750 on drugs last year and needed comprehensive plans that would continue to pay for prescriptions once their annual drug costs exceeded $2,250 and they hit Medicare's "coverage gap."

Both chose one of the highest-priced plans in Texas, with a $58.69 monthly premium.

The strategy of paying top dollar to get the best coverage worked.

Mr. Young expects to save $2,000 on his five prescriptions this year; his wife will save $2,175 on her two drugs.

"We're remodeling our kitchen with the savings," he said. "Everything's fine."

Mignon Harris, 78, Dallas

Mignon Harris tried to stay upbeat when she learned late last year that she would no longer get five free prescriptions from drug makers' assistance programs.

The pharmaceutical companies discontinued their free drug programs for Medicare-eligible individuals on limited incomes once the prescription benefit began. Without that help, her drugs would cost $3,200 a year.

"I had faith that things would work out," she said.

Ms. Harris asked her insurance agent to shop for a drug plan she could afford.

He found one for $14.13 a month that's deducted from her Social Security checks.

So far, she's only had to pay one $38 co-payment for a brand-name drug. "When my pharmacist told me I didn't owe anything, I couldn't believe it," she said.

Ms. Harris estimates that her premiums and co-payments will total $419 this year.

Harold and Marion Avery, 75 and 79, Dallas

Harold Avery and his wife, Marion, had drug coverage through his former employer. But the company dropped the insurance and gave them $543, after Social Security and taxes, to buy Medicare plans this year.

Mr. Avery used Medicare's "drug plan finder" on the Web to identify a $10.31-a-month plan for his wife and a $14.13 plan for himself.

He's on one prescription and figures his out-of-pocket expenses will be $200 this year, about the same as last year.

Mrs. Avery takes 10 prescriptions, for which she paid $1,200 out of pocket last year. She says she won't know until the end of the year whether her Medicare coverage will save her anything.

"I'm worried I'll fall into Medicare's coverage gap toward the end of the year and I'll start to pay the full price of my prescriptions," she said.

Charlotte Hickson, 67, Hutchins

Charlotte Hickson's 16 prescriptions fill the table next to the lounge chair where she spends her days.

Medicaid covered most of those medications last year, and she paid for the others when she had the money.

Because she had qualified for Medicaid, Medicare randomly assigned her to a drug plan.

"It was a mess," she recalled. "When I tried to get my first prescription filled, the pharmacist told me I owed $50. I never had to pay for that drug before."

Ms. Hickson complained to Medicare, which helped her enroll in another plan where she pays no premium, no deductible and no more than $1 for generic drugs and $3 for brand-name medications.

After that initial mix-up, she's had no problems. Fourteen of her prescriptions are covered. The other two cost her $20 a month.

"Medicare pays for more of my drugs than Medicaid did, so I guess I'm better off," she said. "I just hope they leave things be now that they've got the kinks worked out."

E-mail bmoos@dallasnews.com

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Source: The Dallas Morning News

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