Posted At NorthJersey.com

BY : Jessica Adler

Bill Mayer used to get his prescription drugs via mail-order from overseas. Although that is against the law, he wasn't ashamed of doing it. Like many of the estimated 2 million Americans who buy medication from outside the United States, the high price of domestic drugs angered him, and he considered it his right to shop around."I would have to be, as a knowledgeable senior, crazy, out of my mind, to go into a drug store in the United States and order 100 Zocor and pay over $300 when I can get the same item for $100 overseas," he told the Herald News in August 2004.

These days, Bill Mayer, who is 71 and lives in Monroe Township, is a lot less frustrated. In December, he signed up for Medicare Part D drug coverage.

"I was very surprised," Mayer said, recalling his research, in late autumn, on Part D at www.medicare.gov. "It came out that with my three prescriptions (two heart medications, Altace and Toprol-XL, and a cholesterol medication, Vytorin) I had a very sizable savings."

According to a report from AARP, many people could be in a similar situation. It's worthwhile for all seniors ----including those who get their drugs from Canada ----to consider enrolling in a Medicare Part D plan before May 15, 2006, when a late enrollment penalty kicks in, said the report, which was published in the January edition of the AARP Bulletin.

"People cannot tell how they are going to fare and they should do the math, even if they think that they're not going to do better on Medicare," said Patricia Barry, the report's author. "They may be surprised."

AARP supported the Medicare Modernization Act in 2003, which established the drug benefit, and offers a Part D plan of its own.

The study examined how much five seniors would pay annually for their drugs if they enrolled in a local Medicare Part D plan instead of ordering from the online Canadian pharmacy, www.globaldrugsdirect.com. Four of the five would save money with a Part D plan, the report concluded.

"Nearly all our interviewees (who hailed from North Carolina, Oklahoma, Pennsylvania and California) would be better off financially, by varying amounts, under a Medicare plan ----with those using the most drugs potentially reaping the greatest savings over the year," the report found.

It's a tough crowd, though. One Clifton woman who mail-orders drugs from Canada (because that's a crime, she didn't want her name printed) refuses to even consider switching to a Part D plan. It's too confusing, she said.

The number of prescription drug orders to Canadian pharmacies from people in the U.S. is down about 10-to-15 percent since Part D benefits took effect on Jan. 1, said Andy Troszok, president of the Canadian International Pharmacy Association, a nonprofit trade association of 50 Canadian pharmacies. The drop is still relatively small, especially since mail orders also come from younger Americans, who aren't eligible for the new drug coverage.

Of New Jersey's 1.2 million Medicare beneficiaries, 238,000 have voluntarily signed up for a Part D plan, according to data released last week from the Centers for Medicare and Medicaid Services. Another 135,000 were automatically enrolled in the program from Medicaid. Nationwide, 8.6 million (of 42 million) beneficiaries have signed up, and 5.6 million were automatically enrolled.

People who aren't signing up because they get their drugs from Canada could be missing the boat, according to AARP's report. "Many who choose the least expensive Medicare drug plan in their area that covers all their drugs could pay less this year than getting those same drugs from Canada..." it said. "That calculation takes into account all their out-of-pocket costs under a Medicare plan through 2006, including premiums, deductibles and payments for drugs."

Of the five seniors in the study, Donna, from Anaheim, Cal., takes the most drugs (six, including Actos, Fosamax, and Zocor) and would reap the most savings by enrolling in Part D. Her best Part D option would cost about $2,324 annually -- $1,395 less than ordering from Canada. John, from Muskogee, Okla., who takes two drugs (Aggrenox and Synthroid), would save $300 a year by enrolling in his state's Part D plan. Of the five seniors featured in the study, only one would fare worse by signing up for Part D: Joyce, from Charlotte, N.C., would pay $134 annually for Premarin, her only prescription drug, ordering from Canada, compared to $433.36 for her best Part D option.

Prospective savings ----like Part D plan options themselves -- vary depending on an individual's state of residence and specific drug needs.

If they lived in New Jersey, three of the five featured seniors would save money by signing up for a Part D plan, according to the Drug Plan Finder at www.medicare.gov. John, who only takes two drugs, would save about $500; Joyce, who only takes Premarin, would spend about $200 more per year. And Elaine, whose four drugs cost $2,334 when she orders from Canada, would spend about $50 more on a New Jersey Part D plan.

Bill Mayer of Monroe Township, says he will spend a bit more than $600 a year on his Medicare Part D plan -- about $1,100 less than he was spending on Canadian drugs and buying from discount retailers like Costco.

"(Finding a Part D plan) requires that you do your homework and a lot of seniors don't enjoy doing homework," said Mayer, who travels throughout the state as AARP's New Jersey communication coordinator.

His affiliation with AARP has nothing to do with his decision to sign up, he said, adding that like many of his peers, he initially was skeptical of the benefit. That changed once he looked into it further, he said: "(My savings) are black and white."

But Mayer had another reason for signing up: He also wanted to avoid the life-long premium penalties he would incur if he enrolled May 15.

For those considering doing the same, it need not be all-or-nothing, said Troszok, of the Canadian International Pharmacy Association. Some customers, who take only one or two drugs, are choosing to enroll in the cheapest Part D plan available, to avoid the late sign-up fee, while continuing to order from Canada. Others plan to order from Canada once they hit their "donut hole" ----the gap in coverage in some Part D plans once a beneficiary spends more than $2,500 but less than $5,100.

"We're not telling people that Part D is not going to work; we're saying assess it for yourself, put Canada in the mix, see where you come out," Troszok said. "Canada has been around for five years in terms of a robust Canadian mail order program. Next year, (Medicare Part D premiums) have the ability to go up, drug prices can change."

Those ideas aren't lost on Mayer. Premiums will almost certainly increase in 2007, though they must remain within Medicare guidelines. And Mayer dislikes the fact that prices can fluctuate any time under his new drug plan.

Still, when he factored in his savings and the prospect of a late enrollment penalty, signing on to Part D, he said, "was a no-brainer."