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Final Push Set for Drug Sign-Up: Insurers, Government Agencies Extend Hours to Help With Part D

Posted on: Friday, 12 May 2006, 06:08 CDT

By M. William Salganik, The Baltimore Sun

May 12--Local and federal officials are gearing up for a final push to enroll seniors and people with disabilities in the new Medicare prescription program before Monday's deadline.

Several local governments are promising extra hours for phone help and one-on-one counseling. The Maryland Senior Prescription Drug Assistance Program (MSPDAP) has scheduled four sign-up sessions around the state starting Monday morning and continuing until the midnight cutoff.

Nationally, federal officials said this week, about 9 million people have signed up for the Part D prescription plans, of an estimated 15 to 17 million that didn't have coverage before. About half of those who haven't joined, the Medicare agency said, are eligible for low-income subsidies that pay part or all of premiums.

In Maryland, 160,000 have enrolled - but another 200,000 or so don't have coverage. With some exceptions, those who aren't signed up by midnight Monday have to wait until November and face a penalty in higher premiums when they do sign up.

(People who already have coverage - from an employer, union or government program - that's at least as good as Medicare don't have to do anything now. And they won't pay a penalty if they enroll after their situation changes. )

"We're not going to leave someone hanging," said Susan Knight.

She directs the Medicare Assistance Center in Anne Arundel County. Knight said her center will stay open until 7 p.m. Monday, and will offer one-on-one counseling to those who call for appointments. (See box at left for help phone numbers and a schedule of enrollment sessions.)

Richard Popper, executive director of MSPDAP, which offers state premium subsidies to moderate-income seniors (with incomes up to $29,400 for an individual and $39,600 for a couple), said the complexity of the new Medicare program may be causing enrollment to lag. His program has been sending letters and making phone calls to 35,000 people who signed up for a now-discontinued state program to help seniors with drug costs.

Even though they signed up for prescription help in the past, about 5,000 aren't enrolled yet in Medicare programs, according to Medicare records.

"The old program has a one-and-a-half page, large-font application, and one benefit package. There were no bells and whistles. There were no options," Popper said. Medicare offers 66 plans in Maryland, he said - each with "varying premiums, varying co-pays and different benefit structures."

Yesterday at the Overlea-Fullerton Senior Center in Baltimore County, about two dozen people grappled with the sometimes bewildering array of plans.

Carolyn Frey blinked at the computer screen as Larissa Lang, a counselor with My Medicare Matters, told her that one of her medications could cost her $300 under the Medicare prescription plan she had chosen.

"This pill is for my nerves," Frey, 77, gasped. "And now I really need it. I feel like crying."

After Lang explained how she could switch to a different plan, Frey hurried home to begin calling insurers.

To the accompaniment of a cheery polka from the dance class in the next room, Annie Willis, of Overlea, was trying to choose a plan for her brother, who is blind. It was her second trip to the center - she had come in the morning, but had to go back home to get her brother's Medicare card.

As Willis pulled prescription vials out of a Ziploc bag, counselor Sarita Thomas entered them into her computer. She printed out details of two plans that seemed to offer the best deal.

Prices for the medications were similar. One had a premium of just $6.44 a month but a $250 deductible, meaning her brother would have to pay out-of-pocket for months before getting benefits. The other had a monthly premium of $19.90, but no deductible. Willis took the printouts to give her brother the choice; she planned to enroll him, or have him enroll himself, by phone.

The Medicare Web site, and Medicare phone counselors are set up to calculate the annual cost for a specific patient, taking into account monthly premiums, co-payments, deductibles and other gaps in coverage. "Let Medicare do the math," Michael O. Leavitt, U.S. secretary of Health and Human Services, advised during a telephone news conference this week.

Leavitt was participating from a bus somewhere between Detroit and Lansing, Mich., as he hustled between Medicare events. He planned to visit 24 cities this week in the final push.Insurers and pharmacy chains, too, are gearing up for the late enrollment surge. Dominick Washington, a spokesman for UnitedHealth Group Inc., said his company has 3,600 phone representatives, about 1,000 more than it had in January. They went to a 24-hour operation May 1.

"We certainly have seen a significant uptick in calls and applications," he said. United is the largest Medicare prescription insurer so far, with 3.8 million enrolled, the majority in the plan United offers with AARP.

Noven Bhatti, a pharmacist at the Wal-Mart store in Catonsville and the designated Medicare adviser for more than a dozen Wal-Marts stretching from Aberdeen to Glen Burnie, said she conducted enrollment events yesterday in her store and at two senior residence buildings. "Even people who have already signed up have been coming in," she said, "asking, 'Can I get anything better?' " As with enrollment, those who want to switch have to do it by the deadline or wait until the November-December enrollment period for changes that will take effect Jan. 1.

It's not as if federal or local officials or insurers have waited until the last week - even if many seniors had. Leavitt said Medicare had conducted 1,000 guidance events across the country.

Ethel Rasmussen, program administrator for the Baltimore County Department of Aging, said her office had conducted more than 200 educational sessions and 45 enrollment days at senior centers, senior high-rises, clubs, and churches and synagogues.

John P. Stewart, executive director of the Baltimore Commission on Aging and Retirement Education, said his agency had devoted 4,000 staff hours to conducting 267 enrollment and counseling sessions and fielding 5,000 phone calls.

About 45,000 people have gotten recorded "robo-calls" from Mayor Martin O'Malley in the past week, reminding them of the deadline. And with an estimated 22,000 people still needing to sign up in the city, Stewart is adding evening phone hours today, tomorrow and Monday.

He said it's difficult to reach low-income seniors because some don't speak English - he's sent out counselors who speak Spanish, Korean and Russian to neighborhoods where that would help - and as many as 25 percent have dementia or other cognitive impairments.

Critics of the program say Medicare has underestimated the number of people who still need to be reached. But one of those critics, Robert Hayes, director of New York-based Medicare Rights Center, said flaws in the program are "next week's story."

For now, he said, "I'm sure that everybody who has no coverage should dig in deeply and pick a plan that works for them."

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Source: The Baltimore Sun, Maryland

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