Medicare Mailing May Confuse Recipients

The Social Security Administration has just begun mailing millions of letters to low-income people on Medicare. These are people who may qualify for financial help with a new prescription drug benefit. But some advocates for the elderly say the letters are more likely to confuse the recipients than to help them.

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The Social Security Administration has started mailing millions of letters to low-income people on Medicare. These are people who may qualify for financial help with a new prescription drug benefit. As NPR's Joanne Silberner reports, some advocates for the elderly say the letters are more likely to confuse the recipients than to help them.

JOANNE SILBERNER reporting:

The critics point to something that happened a year ago, the introduction of a drug discount card for Medicare recipients and people with low incomes could get their first $1,200 worth of prescription drugs over a two-year period paid for. When the benefit became available, Pia Scarfo went out and talked to people at senior centers around New York City to try to get people to sign up. She's with a service and advocacy group, the Medicare Rights Center.

Ms. PIA SCARFO (Medicare Rights Center): People before and after, we try to clarify; they were extremely confused.

SILBERNER: Some thought they were getting a money card with $1,200 on it. Others didn't understand they had to be enrolled in Medicare. Only about 25 percent of those eligible for the benefit enrolled.

Ms. SCARFO: They didn't sign up. It's all because they were confused, and all because they didn't know and the information they would have--receiving by mail was not clear.

SILBERNER: Now Medicare's getting ready for the second phase of the program, and they're trying to get more people to sign on. In the second phase, Medicare recipients pay premiums to insurers who negotiate discounts for specific drugs. The drugs are nearly free for Medicare recipients who meet certain criteria, such as individuals with incomes below $14,000 a year. Medicare administrators are trying not to make the same mistakes. Mark McClellan is head of Medicare.

Mr. MARK McCLELLAN (Head, Medicare): This is a more comprehensive benefit and we have more time to prepare to implement it. So we're sending out this mailing more than six months before the actual benefit starts so that we've got more time to reach people and we're backing that up with lots of community and grass-roots events that for the drug card we didn't have time to do.

SILBERNER: And he says Medicare has designed a very simple application.

Mr. McCLELLAN: It's only four pages of questions in large type. There are a total of 16 questions and most people only have to answer 12. If you can't answer all of them, we encourage you to answer the ones that you can and send it in and then we'll help you over the phone with the rest of them. And there is no need to attach any extra information.

SILBERNER: But a test mailing has already caused some confusion. Pia Scarfo of the Medicare Rights Center says she had to help a man who got one of the pilot mailings who didn't know how to fill out the part about how much financial assistance he receives from family and friends. Robert Hayes, head of the Medicare Rights Center, says the forms are tough.

Mr. ROBERT HAYES (Head, Medicare Rights Center): Frankly, I have to read a number of these questions several times to understand them. And, you know, I went to a pretty decent college and a pretty decent law school.

SILBERNER: People may be confused that though they can apply now, the benefits don't start till January. And there's a part that may scare people off that says `Inaccuracies could lead to imprisonment.' But Medicare head McClellan says it can be done.

Mr. McCLELLAN: I'm optimistic that we're going to do better than previous government programs like Medicaid programs when they first started because we are taking all of these additional steps to reach this very hard-to-reach population.

SILBERNER: The program is being administered by private insurers, not the government, and in a few months people will have to select which insurance carrier to sign up with. Joanne Silberner, NPR News, Washington.

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