WASHINGTON – Maryland’s stop-gap early refill program, devised to help senior citizens transition into Medicare’s new prescription plan, has wound down, leaving some elderly citizens scrambling to get their medicine.
Maryland anticipated the problem with the Jan. 1 transition to Medicare Part D and so allowed those eligible for both Medicare and Medicaid to receive an additional refill in December. About 15,000 people participated.
With those refills now running low, senior citizens continue to be confounded by the new Part D plan, support centers are struggling to help clients figure out their correct plan and there’s no new state support for those who are falling into the coverage gaps.
More than 20 other states, and the District of Colombia, have already set aside funds for prescription assistance.
Maryland health officials plan to make an announcement soon regarding the problem, but no details are available.
The state’s early refill program “seems to have helped significantly,” said Jeff Gruel, director of the Maryland Pharmacy Program.
“That helped a lot of people, but it helped those who were aware,” said Susan Knight, Senior Health Insurance Program director for Anne Arundel County. Because mailings went out during the December holiday season, many eligible seniors may not have gotten the word, she said.
“People have to be aware, (the Centers for Medicare and Medicaid Services) were referring people to a Web site. Many seniors are unfamiliar with dealing with a Web site,” said Joy Hatchette, associate commissioner in charge of the Consumer Education and Advocacy Unit for the Maryland Insurance Administration.
The amount of confusion caused by the plan has surprised Gruel.
“I didn’t expect to see this significant of a problem. Nobody anticipated this,” said Gruel.
The Maryland Department of Aging has received about 2,700 calls since enrollment opened in November, and counseled more than 400 seniors, according to department Secretary Jean Roesser. Others calls were referred to more suitable agencies.
“We are very, very busy,” Roesser said. The department has trained 30 of its 60 staff members to help those bewildered by the program.
“It’s a complicated program, it takes time to explain it,” she said. Finding the best program requires one-on-one attention, according to those working to help ease the confusion.
“It’s pretty complex, I give the seniors great credit,” Roesser said.
The greatest amount of confusion seems to have come from those enrolled in both Medicare and Medicaid, where the “duel eligible” members were automatically enrolled in plans that did not necessarily fit their needs. When the plan came into effect Jan. 1, the problems started.
And the dual eligible population often has the greatest need: They are generally low income participants, some with significant health problems including psychiatric illnesses.
Those attempting to pick up prescriptions encountered numerous problems at pharmacies, from not showing up in any plan, to being enrolled in plan that did cover their medicines, to being charged a large fee for a normally affordable prescription.
“People were walking away or having to pay exorbitant fees,” said George Kelemen, campaign manager for the AARP Medicare Rx Outreach Campaign.
If pharmacists are able to verify that the customer has dual eligibility, an extra supply of medicine should be provided, but verifying the information often proves difficult.
“Pharmacists are overwhelmed,” said Leta Blank, Senior Health Insurance Program coordinator in Montgomery County.
The predicament of some seniors “is truly a travesty,” said Anne Arundel County Executive Janet Owens. “It’s like the IRS sending the tax code to citizens. We’ve confused so many vulnerable people.”
Anne Arundel County is opening a Medicare Part D Assistance Center this week.
“We’re trying to help those seniors who are home alone. The impact is so potentially harmful and dangerous,” Owens said.
“We’re going to reach out and touch everyone we can,” said Knight.
Not all senior citizens had trouble with the plan.
“Being somewhat of an adventurous person, I thought it was very easy,” said Albert Johnston, an “82-plus” retired personnel director.
Johnston, who spent part of his career explaining benefits to others, has helped neighbors and other members of his AARP chapter in Severna Park sign up for the correct plan.
“The program works,” he said.
“The overall program is going quite well. They’re saving money,” Kelemen agreed.
Call volume has been lessening on some fronts, as enrollment problems are corrected. Calls to Gruel’s office have gone from 100 per day at the beginning of January to 37 last Friday.
Optimism permeates most of the workers helping to explain the plan, which is slated to save seniors money, once the complications are worked out.
“The glass is half full,” said Blank. “It just needs a little help.”