Posted At Princeton Daily Clarion

BY : B.J. Hargis

There has been a lot of confusion about Medicare Part D, the federal government's new prescription drug program.

Since May, when about 20 million Medicare beneficiaries were notified of the change in the system, the government has hired over 10,000 Medicare counselors to handle all the questions.

"It is not like A and B (Medicare) at all," Joseph C. Kendall, field representative in the Evansville office of the Social Security Administration, said during a community education program Thursday at Gibson General Hospital. "If you think about Part D like that, you will be confused and frustrated. You will get Part D through private insurance companies, not the government."

He added that the 18 private companies that will offer 22 prescriptions drug plans to Indiana residents had to pass government regulations to be put on the list."All the companies had to be checked out by the U.S government," Kendall said. "You can't get on the list without first meeting government specifications. Even though the government is trying to privatize Medicare, they still have a hand in it, at least at the beginning."

With a potential market of 30 million customers, Kendall said competition will hopefully lead to a price-friendly market.

"Obviously there are a lot of consumers that these companies will be trying to attract," Kendall said. "Hopefully that will make the market very competitive, which should mean lower prices for the consumers."

He added that these companies can raise prices for deductibles and prescriptions, but not without a 60-day advance notice.

"That does not grant a person the right to change the company they chose to provide prescription drug services," Kendall said. "But the fastest way to lose customers is to increase the premiums. These companies wanted to see how it plays out before they start increasing the premiums."

Medicare's new prescription drug coverage, which begins Jan. 1, 2006, is voluntary and seniors can choose not to enroll, but face a penalty if they decide to sign up later.

"You have to have Medicare Part A or Medicare Part B to be eligible," said Kristin Hood, the wellness coordinator at Southwestern Indiana Regional Council on Aging. "The enrollment period continues through May 15, 2006. But if you need coverage up and running by Jan. 1, you have to enroll by Dec. 31. Coverage will begin the first of the day of the next month after you sign up."

She also said if you don't sign up by the deadline and want to later that a one percent penalty per month will be added to your premium.

Hood went on to say that changes can only be made during the annual enrollment period of Nov. 15 to Dec. 31, starting in 2006, with the exceptions such as change in residence and loss of creditable prescription drug coverage.

Hood said that the handbooks "Medicare & You 2006" were mailed in October, which listed prescription drug plans in the area. She added the that those needing additional help can call 800-MEDICARE (633-4227) 24-hours a day or log onto the Internet at www.medicare.gov.

"They will help you fill out the form, print it out and mail it to you," she said. "I tell people about the three Cs, coverage, cost and convenience. You have to make sure your prescriptions are covered by the plan as not are all plans cover all prescriptions. You have to make sure the cost of the premiums fit within your monthly budget. The third C is convenience. Find a plan that allows you to go to your pharmacy of preference."

According to Hood, the Medicare web site can help you shrink a large list of choices down to a top five. She added to make sure consumers get a stand-alone prescription drug plan instead of one that has medical coverage.

"You should already be receiving medical care with Medicare," said Hood. "You wouldn't believe how many people I've met that couldn't take all of their medicine or not take it at all because they couldn't afford to pay for the prescription. Hopefully this will allow everyone to get what they need in order to stay healthy."

The standard benefits include monthly premiums of $32 with a $250 deductible. There is a gap in coverage from $2,250 to $5,100 in drug expenses. After the gap, customers pay the greater of 5 percent or a CO-pay of $2 for generic and $5 for brand name drugs.

"If you have a higher premium, you pay less out of pocket expenses and vice versa," said Hood. "But every plan is different."

Hood reminded those attending the program that they need to check with their insurance carriers to find out if the coverage they have is as good or better than Medicare offers.

"You have to have creditable drug coverage, such as those with both the dual coverage of Medicare and Medicaid, VA benefits, military retirement benefits or anyone with federal health benefit plans," Hood said.

She added that discount prescription cards will no longer be available after Dec. 31 and that drugs from Canada cannot applied to the program.

Hood said to avoid fraud, approved plans must have the Medicare seal and to make sure you never give out your social security number unless you are sure the person on the other phone represents a legitimate prescription drug plan.