Sorry, I don't get the connection...
Posted on 11/16/2005 7:50:43 PM PST by SierraWasp
Confusion greets drug-plan sign-up
Legislators, consumer groups balk at Medicare Part D
By Kristen Gerencher, MarketWatch Last Update: 7:29 PM ET Nov. 15, 2005
SAN FRANCISCO (MarketWatch) -- A dizzying array of options in the new Medicare prescription-drug benefit is confusing many beneficiaries who don't have enough time to make the decision without incurring a financial penalty, a group of lawmakers charged Tuesday.
U.S. Sens. Richard Durbin, D-Ill., Bill Nelson, D-Fla., and Chuck Schumer, D-N.Y., along with U.S. Reps. Jan Schakowsky, D-Ill., and Pete Stark, D-Calif., announced legislation that would give Medicare beneficiaries a full year to choose a Medicare drug plan instead of the six months now allowed.
The benefit, known as Part D, is set to replace the transitional discount-drug-card program on Jan. 1 for those who enroll in one of the many private insurers' drug plans by then. The six-month penalty-free sign up period began Tuesday. Those who fail to sign up within the six months face a benefit penalty of 1% a month.
The drug benefit marks the biggest change to Medicare in its 40-year history. It's forcing many of the federal program's 42 million beneficiaries to compare their current drug coverage with the new plans and weigh which is best.
Among other factors, seniors and those who are disabled need to consider what they can afford in premium costs, deductibles, copays and coverage gaps. They also need to compare each plan's list of covered drugs to ensure the drugs they're taking and the pharmacies they buy from are included under the different plans.
"We have created a plan here that is so difficult, so confusing and so hard for average people to understand that many seniors are struggling to try to figure out what is the best plan to turn to in order to protect themselves," Durbin said during a press conference.
"It didn't have to be this way," he said, noting that the law could have created a simpler approach and given Medicare the right to bargain for bulk discounts, "just like the Veterans Administration so that, ultimately, the seniors would have been the winners."
"As it turns out, the seniors are going to be the victims -- at least for the next few months while they struggle through this terrible transition trying to figure out how many plans to choose from," Durbin said.
Bills introduced
Durbin is cosponsoring a bill called the Medicare Informed Choice Act along with Schakowsky and Stark on the House side. The bill, H.R. 3861, would extend the penalty-free enrollment period until Dec. 31, 2006 and allow beneficiaries to make a one-time change in their plan in the first year in case they make a mistake.
"Remember, we had three very rude visitors this year: Katrina, Rita and Wilma," Nelson said. "That has disrupted the lives of senior citizens in the Southeastern United States considerably."
"And in the midst of all that confusion, to add this additional burden and not give them the luxury of some additional time after what they've suffered, that would be inexcusable."
Schakowsky and Marion Berry, D-Ark., also introduced H.R. 752, the Medicare Prescription Drugs Saving and Choice Act, which would provide the drug benefit within Medicare instead of through private insurers and require the program to negotiate prices with drug companies to hold costs down.
The law that created the Medicare drug benefit expressly prohibited the program from bargaining for lower prices with drug companies. That provision remains a sticking point among critics such as Ron Pollack, executive director of Families USA, a national health-care consumer advocacy group, who sees the estimated $700 billion cost of the drug program over the next 10 years as unsustainable.
"I believe as the costs of this program skyrocket and people want to trim wasteful spending, they're going to want to revisit the way the program was structured," he said.
What seniors can do
As seniors prepare to make their selections, the Centers for Medicare & Medicaid Services is touting its Plan Finder tool at www.Medicare.gov, which is designed to help beneficiaries find a drug plan that works for them. See previous Vital Signs for more information.
But like many online and phone support tools, it's been overwhelmed and running slowly because of the demand for services, Pollack said.
The problem isn't just technical -- about 76% of seniors have never been online, he said. "Even if the tool works better as I presume it will, it still won't be helpful for most of the people in this population."
What's more, 26% of Medicare beneficiaries have cognitive impairments, 2.3 million live in nursing homes and more than 3 million seniors have visual problems, he said.
Those having trouble choosing a plan may want to visit one of the 1,100 State Health Insurance and Assistance Program offices, also known as SHIP, for help, Pollack said. Most are staffed by volunteers who can aid people in comparing plans, he said.
"Seniors will need one-on-one counseling because there's no one answer for everybody," he said. "You may even have a husband and wife and what may be good for one may not be good for the other."
People who can't find a SHIP office near them may call Families USA for a referral at 202-628-3030.
Many still uncertain
Medicare's standard benefit, which companies may deviate from as long as they offer more and not less, is structured so enrollees pay a $250 deductible upfront before insurance kicks in, plus premiums ranging from about $20 to $37 a month. Beneficiaries are responsible for 25% of costs from $251 to $2,250. After that, the plan stops paying in the so-called doughnut hole, where enrollees pay for costs up to $5,100, after which the government program picks up 95% of the tab.
Despite private insurers' sizable ad campaigns to sign up seniors, 43% of eligible Americans said they don't know yet if they will enroll in a Medicare drug plan for 2006, according to a study released last week from the Kaiser Family Foundation and Harvard School of Public Health. One in five say they plan to enroll but 37% say they don't plan to sign up.
When asked whether the new drug benefit would help them personally, more seniors say it wouldn't help them than say it would -- 49% and 39% respectively.
Consumers Union, the publisher of Consumer Reports, launched a Web site two weeks ago at www.consumersunion.org/issues/medicaredrugs that invites seniors to report aspects of their experience in obtaining Medicare Part D coverage.
So far, about 100 people have written in with vague complaints about the sign-up process, said Bill Vaughan, a senior policy analyst at Consumers Union.
"It basically is just, 'I don't understand. It's too confusing. It's not clear,'" he said. "'Why does it have to be so complex?'"
Vaughan advised frustrated seniors to be patient with the tools and keep checking back in the next six weeks. "The prices are likely to change; the accuracy of the information will get better."
Kristen Gerencher is a reporter for MarketWatch in San Francisco.
It is a federal fuster cluck that is going to cost a fortune. Should anyone be surprised?
If people opted not to join in mass, I could learn to love the plan.
This is the thing that won the last Presidential election for the nation's Grand Old Party!!!
You better be more careful about makin those disapproving comments in the face of all the political and conventional wisdom contained within this fabulous website, don'tchew think???
I cain't stop laffin an gaspin fer breath!!!
This is just the beginning of another disaster of social policy -- this time courtesy of the wimpish Bush-era Republicans energetically lining up to kiss socialist arse. The logical extreme (reductio ad absurdum) of such Federal entitlement programs must of course lead to spoon-feeding of the useless eaters.
I don't believe that this was a Republican plan - it was a rehash of the Democrats plan - or the bureaucracy and staff of the Democrats - with a little bit of extra for the masses and the drug companies.
I did not want a Medicare "formulary" like the VA has, but I think it would have been better than what we're ending up with.
It seems that the prescriptions have to be sent electronically to the pharmacies. Rural docs and mom and pop pharmacies are going to be stressed. And then, there's the first dollar coverage problem: it covers everyone from the beginning - then cuts off when the patient needs to spend a lot on drugs. Then kicks in after quite a bit of out-of-pocket expenses.
Once again, everybody gets $1.00, whether they are millionaires or broke. And those with the really big bills will end up indigent and on Medicaid.
The other problem is the burden that will be supposedly on the family doctors. I don't think that most of the docs I know can afford another employee just for Medicare Part D claims.
I hoped for some sort of plan, but it does seem as though they took the worst of all possibilities and only chose those.
The problem is that I don't know if we will learn some valuable lessons from the monstrous disaster that Medicare part D is turning out to be, or if it will just be one more excuse to nationalize healthcare.
Well, as you can see, you better pray a little harder as they are determined to turn everything he did to get re-elected into a bigger and bigger liability to him, politically!
They started hating him for not rolling over for Algore in 2000, but their hate turned white hot when they had to shut up their cresendo of criticism immediately after 9-11 and he used A WAR and the theft of these SOCIAL PROGRAMS to steal governance from them one more time!!!
Look at their faces on TV! They are becoming consumed with hate!! But we may become consumed with these danged programs!!!
The simple discount program is out the window as of 1-1-06! There will still be discounts (removal of artificial mark-ups) but mainly you'll either have to sign up with a Medicare HMO, buy a prescription insurance from an insurer, or just go naked and take your chances with whatever discount programs, or internet sales, or out of country (Mexico/Canada) purchases... and that' about it!!! (not that there's anything wrong with that)
Sorry, I don't get the connection...
Please God tell me there's a way I can stay out of Medicare!
There's only 2 kinds of drivers that serew up traffic worse than Volvo drivers and that's drivers of VW busses and illegals without a licence.
Equally bad are drivers blabering on a cell phone.
I thought we should have gone into Iraq. Since then I've tried to remain positive about how the war was conducted. For the most part, I think Bush has done a pretty good job with regard to the war.
As for the rest of Bush's actions, he's blown about ever issue from a true conservative's point of view.
I've said this repeatedly on the forum, and specificly on topic after topic.
I try not to trounce him because that would play into the socialists hands, but it's hard not to.
The guy can't even conceptualize that we shouldn't allow 10,000 Wasabbi adherants from Saudi Arabia to come to the U.S. for schooling.
You haven't seen me address these and other issues on the forum?
That's easy! Move to Borneo!!!
Nope!
Especially when they're all woosey from prescription drugs! (grin)
Equally bad are drivers blabering on a cell phone.
I don't know what language "serew" is.
What about people who drive all the other vehicles you don't approve of, do you hate them too?
Is opting out an option? And even if you want to, will any other insurance you have allow it? Seems to me that other insurers will be only too happy to foist their customers off on Medicare first.
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