ANNAPOLIS – For the past 27 years, Helen Crane has relied on Medicare to help pay for her health care expenses. Now 82 years old, she’s trying to choose a plan to cover her $500-per-month prescription drug costs before a new prescription drug program takes effect in two months.
Because of her poor eyesight, Crane relies on her daughter to read the fine print about the plans to find the one that’s best for her.
“We really need help,” said the Crownsville resident as she played a game of cards at the Annapolis Senior Center. “It’s very confusing.”
Crane and all of Maryland’s other Medicare beneficiaries must decide whether to join Part D – a voluntary insurance plan that covers a portion of prescription drug costs – by Jan. 1. Then, if they join, they must select from among 40 plans.
The program’s complexity has left many of the 674,000 Marylanders enrolled in Medicare more perplexed than ever.
To respond to the growing number of inquiries from elderly Marylanders, state agencies have set up outreach programs at some senior centers, nursing homes and health fairs.
“It’s just a mess,” said Sen. Katherine A. Klausmeier, D-Baltimore County, who said she has been deluged with calls from bewildered constituents seeking help with Part D. “It’s pretty bad we have to hold a Senate hearing to explain it, but poor old Mrs. Smith in the back of the senior center walks out with glassy eyes. And for the seniors who can’t get to the senior center, God help them.”
Richard Popper, executive director of the Maryland Health Insurance Plan, said his office has mailed information to current Medicare recipients, including a 54-page guide to the 40 individual plans, which all feature different premiums, co-payment charges and drug lists.
Popper’s office has spent $500,000 in grant money to put on more than 50 outreach programs throughout the state, and $130,000 to send representatives to nursing homes to help seniors choose a plan.
“There’s a lot of variation between the plans,” Popper said. “It is going to require a lot of research on the part of our members.”
The program presents choices that are especially difficult for nursing home residents, who have to consider the facility’s available services when choosing a plan. Also, seniors who choose not to join Part D this year because they have generous coverage from retirement plans will have to pay a penalty if they join in the future.
Another problem is the lack of reliable information available from federal sources, said Susan J. Vaeth, who heads Client and Community Services for the Maryland Department of Aging.
A Web site designed to help enrollees find a plan is incomplete, and some of the 800 callers to her office about Part D have complained they’ve gotten “the run-around” from the federal call center.
“The main challenge is the complexity of the program,” said Department of Aging Secretary Jean W. Roesser. “There’s a lot for (people) to consider.”
Starting Nov. 15, enrollees have six months to sign up for one of the prescription drug plans without having to pay a penalty. About 68,000 current Medicare beneficiaries receive prescription drug coverage through other state-run programs, like the Senior Prescription Drug Program and the Pharmacy Discount Program, which expires Dec. 31.
Some of them are automatically eligible for the program, but will have to fill out separate applications to receive low-income assistance. All of the state’s Pharmacy Assistance Program enrollees are eligible for Part D, but about 7,000 have not yet applied, according to Charles Lehman of the Department of Health and Mental Hygiene.
“I’m sure there will be people who lose service because they’re not paying attention,” Vaeth said.
Even those who know about Part D don’t know where to turn for help.
Bill Blanding, 64, of Bay Ridge, has a lot of questions to ask. Although he doesn’t take any medication now, he wants to sign up for coverage in case he needs prescription drugs in the future. He plans to meet with insurance representatives when they visit the senior center later this month. “I just need information so I can sign up and avoid the penalty.” – 30 – CNS-11-1-05