Posted At West Central Tribune
BY : Clay Robison
Jean Newman is hardly afraid of challenges. The 73-year-old Cuban native came to the United States as a teen, worked for years as a substitute teacher and volunteered in the Israeli army well into her 50s.
But when it comes to the new Medicare prescription drug benefit, she is at a loss.
The whole thing is so confusing. It might as well be in Chinese, Newman said.
Millions of senior citizens will become eligible for the benefit Jan. 1, but many dont know whether it will save them money, or which private insurance plan they should choose among the dozens that have bombarded their mailboxes with ads in recent months. Many dont know how to apply or whether they are even eligible. And many are asking: Will the medications I need be covered?Those who fail to sign up by May 15 may not get coverage until 2007.
Not surprisingly, the people who seem to know the most tend to be the more educated and more affluent the ones least likely to need the new coverage.
About 42 million people are eligible for the Medicare drug benefit. As of mid-December, nearly 20 million were enrolled in some form, but the vast majority of them were automatically switched over from other benefit programs, including Medicaid. Only about 1 million had joined voluntarily.
Newman spends about $150 a month on Prozac and the thyroid supplement Levoxyl. She applied for the low-income assistance but was rejected. Now she is unsure whether she is eligible for any of the coverage. (She is).
Theres a thousand different forms of confusion, but almost everyones confused, said Robert Hayes, head of the Medicare Rights Center, a consumer group.
The government has touted its Web site, http://www.medicare.gov, where senior citizens can compare plans on spreadsheets, and it has urged people to consult their families and their doctors.
Hayes said its unrealistic to expect doctors to shoulder the burden of explaining the plans. In an ideal world, which is long past in this economy, physicians could sit down and become experts and counsel their patients. That doesnt happen today because theres so much time pressure on every doctor, he said.
Those who have done their homework are finding that the new program doesnt always offer advantages.
Mark Silverstein, 66, of Philadelphia, enrolled in one of the prescription plans because he was told his current Medicaid program would no longer be offered after Jan. 1. He called Medicare, told a representative which medications he takes, and was signed up for a plan that he said would cost him $15 a month.
But then Silverstein found out that his medicine might be covered by the Veterans Administration because he served in the Army. Silverstein said he is going to look into that option.
In Tucson, Ariz., Jerry Lacker said he has enrolled in the program but found the gap in its coverage puzzling. Many plans cover annual drug purchase of up to $2,250, but then senior citizens must pay the full cost of the rest of their drugs until they have spent $3,600, at which point Medicare kicks back in.
