Marketing of Medicare Drug Benefit Stirs Confusion
STEVE INSKEEP, host:
We are about a month into the marketing for Medicare's new prescription drug benefit. Seniors have been complaining for some time that they're confused about what this means for them. And people helping seniors choose among a myriad of plan options say they still do not have enough information. NPR's Julie Rovner has been covering this story and has our report this morning.
JULIE ROVNER reporting:
Enrollment in the private Medicare drug plans doesn't start until November 15th for a benefit that begins January 1st. But seniors are already anxious, says Leta Blank, program director for the Montgomery County, Maryland, Senior Health Insurance Program.
Ms. LETA BLANK (Program Director, Senior Health Insurance Program): It is a complicated undertaking and it's very scary for people.
ROVNER: Blank has two staffers and about 25 volunteers to help 116,000 seniors navigate through literally dozens of options for drug coverage in her state. Add to that even more variables--whether a person already has drug coverage, what drugs he or she takes and in what amount--and she says it all becomes nightmarishly complex.
Ms. BLANK: It means actually getting on a computer with each of the beneficiaries and plugging in what they have. And we've found it's almost drug by drug that you have to come back with which plans carry the drugs that you want and at what price.
ROVNER: In Illinois, things are just as confused, says Democratic Senator Dick Durbin. He's one of a group of Democrats in the House and Senate who want to give Medicare beneficiaries more time to choose or change plans without penalty. As it stands now, anyone who enrolls in a drug plan after next May 15th will have to pay a higher premium.
Senator DICK DURBIN (Democrat, Illinois): This is somewhere between a bureaucratic nightmare and elder abuse. There are 17 insurance companies offering 84 different Medicare, HMO and PPO plans in the state of Illinois. There are 16 prescription drug organizations offering 52 different prescription drug benefits; a total of 136 different plans in Illinois.
ROVNER: But Medicare administrator Mark McClellan says people need to stop and take a deep breath.
Mr. MARK McCLELLAN (Medicare Administrator): As long as you sign up before January 1st, you can get coverage starting on January 1st when the program begins. So there's plenty of time and this is a good time to start having a conversation to find out about the kinds of options available and get ready to make a decision about the coverage that's best for you.
ROVNER: Health insurance counselor Leta Blank says Medicare beneficiaries who want to sign up for a Medicare drug plan need to do a few things to prepare.
Ms. BLANK: What we're asking people to do is to get a list of all the drugs that they take, the dosage and the price. And we're asking them to prioritize the list according to how much they spend each month on each drug.
ROVNER: That's because a plan might pay for some of the drugs a person takes but not others. But Blank says right now it's still not possible to actually compare how a plan would work for a specific person because there's no pricing information for individual drugs.
Ms. BLANK: And that is a big consideration because maybe some of the zero-deductible plans might tier their cost of the drugs high so that you might be better off spending the $250 than going into the tier system of some of these co-pays.
ROVNER: In other words, a plan that seems to cost less, with lower premiums or deductibles, might not if it charges more for the drugs an individual needs. Complicating matters further is that there are mistakes in the printed Medicare handbook and some of the promotional material. Lawmakers like Senator Durbin are afraid of what may happen to them if seniors can't navigate through all their choices.
Sen. DURBIN: Hell hath no fury like America's seniors if they feel that they're not being treated fairly. And as they get into this program and look at the mess that's been created by this administration, and realize that if they guess wrong, they're going to be penalized, we're going to hear from them. And we're going to hear from them a lot.
ROVNER: The last time Congress tried to add a drug benefit to Medicare, the costs were so unpopular that lawmakers repealed it a year later. That's not likely this time, but if implementation doesn't go smoothly, seniors could well take out their frustrations at the polls next November.
Julie Rovner, NPR News, Washington.