Only 8 Days Left to Enroll: Seniors Over 65 Have Just Over a Week to Enroll in Medicare’s Part D Prescription Drug Benefit Without Incurring a Penalty

By Monica Hatcher, The Miami Herald

May 7–You wouldn’t wait until a hurricane was in the forecast to buy homeowners insurance. So why would you wait until you were sick to buy prescription drug insurance?

With just over a week left to enroll in Medicare’s new prescription drug benefit plan, an estimated 190,000 South Floridians eligible for the government-subsidized coverage have yet to sign up.

Seniors 65 years and older and some people with disabilities have until May 15 to choose from more than 100 discount prescription drug plans offered in Florida under Medicare Part D.

The sheer volume of choices flummoxed millions prior to the Dec. 31 deadline for the benefit that first took effect Jan 1. As the six-month enrollment period for 2006 comes to an end, the complexity of picking the right plan is still a top reason why some seniors have put off joining, according to survey results released last month by the Kaiser Family Foundation.

Others already have good coverage or feel they take too few medications to justify getting a new plan.

P.J. Merendino of Aventura put off her decisions on a plan until Wednesday night, when she attended an information session at Mystic Point Condominiums.

“Mostly it’s because it seemed so confusing, and we’ve been so biased by all the negative press about how we oldsters are being taken advantage of,” said Merendino, 71.

THE COST OF WAITING

But for those who have no coverage, there is a good reason to take the May 15 deadline seriously.

“The penalty is 1 percent per month, but effectively you can’t get a benefit for seven months after May 15, at which point your premiums will be at least 7 percent higher than the national average,” said to Bill Vaughan, a senior policy analyst with Consumers Union in Washington.

That 1 percent penalty compounds each month.

Additionally, seniors will have to wait until Nov. 15 to enroll for benefits that start in 2007, a fact many don’t know, Vaughn said.

Low-income recipients, on the other hand, can enroll at any time without penalty.

Avoiding the lifelong penalty is indeed the incentive some seniors have needed to pick a plan, including Merendino, who said she was alarmed by her physician son when he told her about the cost increases.

“I got panicky about it. He said the penalty you pay is the penalty for the rest of your life.”

WHAT PLANS COST

The average monthly premium in Florida is about $32, said Lee Millman, a regional spokeswoman for the Centers for Medicare and Medicaid. But some experts predict the average may jump next year as the cost of prescription drugs continue rising.

‘We have to get more people thinking, ‘Gee, just because I’m healthy as a horse today doesn’t mean I shouldn’t get health insurance.’ If you don’t have drug coverage for today’s modern medicine, you could go bankrupt real quick,” Vaughan said.

The standard Medicare prescription drug benefit allows for up to a $250 deductible, then pays for 75 percent of medications up to $2,000. Recipients are responsible for covering the next $2,850, a coverage gap also called the “doughnut hole.” After that, the plan picks up 95 percent of the tab.

More than 30 million of some 47 million eligible Americans now have some sort of prescription drug coverage, according to the CMS.

The new benefit is intended to save 80 to 85 percent of seniors at least 50 percent of their drug costs. Others will break even or pay more, CMS has said.

PAYING MORE

But some studies have shown as many as one in five are paying more for their medications than before, including low income beneficiaries that got medications for free but now pay between $1 and $5 per drug, those who had cheaper employer retiree coverage and those who had no coverage before and don’t need drugs but are paying for a new plan.

After their Medigap insurance phased out their prescription drug benefit, Berton and Doris Pressman of Coral Gables saw their drug costs rise by about $70 a month.

“If I didn’t subscribe at all, it would cost me still more, so I am obliged to subscribe,” Berton Pressman, 79, said.

For Vincent Branda, 80, a semi-retired dentist living in Aventura, the savings under his new plan were minimal but no less helpful at about $1,000 a year.

But after enrolling Wednesday, Merendino found she would go from paying about $300 a month for her medications to $97.

“That’s certainly better than a sharp stick in the eye,” she said.

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Copyright (c) 2006, The Miami Herald

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