Adults Often Help Parents with Medicare Drug Benefit

Many seniors are depending on their adult children to help them get registered for Medicare's new prescription drug benefit. Julie Rovner introduces her own mom and other seniors who even go to classes to figure out how the benefit works.

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RENEE MONTAGNE, host:

This is MORNING EDITION from NPR News. I'm Renee Montagne.

In our personal health segment today, Medicare's new prescription drug benefit. It begins next month. It's not just seniors who are befuddled by all the choices. Many of their baby boomer offspring are also having trouble figuring out which plan is right for Mom or Dad. NPR's Julie Rovner has been covering every detail of the new program since its inception, but even that didn't spare her confusion in trying to choose a plan for her mom.

JULIE ROVNER reporting:

All year long, Medicare officials have been urging adult children to help their parents navigate the Medicare prescription drug maze. My mom's a prime candidate for the new drug insurance because she doesn't have retiree drug coverage. At a meeting a couple of weeks ago, she said she's pretty happy with the Medigap drug coverage she has now. But she knows she should probably change.

Unidentified Woman #1: Although I don't pay that much for drugs now. I don't have that many drugs that would--that are expensive or new. Who knows what will happen tomorrow?

ROVNER: So following Medicare's instructions, Mom gave me the names and dosages of the half-dozen drugs she takes, then I got on the Web and plugged all her information into Medicare's program. As promised, it gave me a list of plans, but there was more than $1,000 difference in predicted costs and I couldn't figure out why. Thus began our quest for outside help.

OK.

Unidentified Woman #1: OK.

ROVNER: Do you have your car keys?

Unidentified Woman #1: No. They're hanging on the fridge.

ROVNER: Our first stop was the computer club at Mom's retirement community outside Washington. That's where Erwin Schaeffer(ph), a semi-retired pharmacist, has been gathering residents in front of computer terminals and walking them through the selection process.

Mr. ERWIN SCHAEFFER: There are some plans which you will pay for the same drugs as little as $2,000 and as much as $9,000 for the same drugs, only with a different company.

ROVNER: There were lots of questions from the 10 or so seniors seated at the computers, even before the hands-on part began.

Unidentified Woman #2: If it's 22.50 and I've noticed in the book some plans don't have a deductible...

Mr. SCHAEFFER: Right.

Unidentified Woman #2: ...so is it 2,500 without the deductible or is it...

Mr. SCHAEFFER: No, it's...

ROVNER: And here were more than a few false starts when people started entering the lists of drugs and dosages they take.

(Soundbite of meeting)

Unidentified Man #1: That's additional.

Unidentified Woman #3: ...(Unintelligible)

Mr. SCHAEFFER: OK, you have to do that and the drugs, then stop.

ROVNER: Eventually, everyone managed to get that far.

Mr. SCHAEFFER: Then--now we're going to choose a pharmacy. Click on `select my preferred pharmacy.'

Unidentified Man #2: OK. Where's he see that?

ROVNER: And after a few more minutes, there were the top plans. But Mom and I were still confused.

Unidentified Woman #1: This is how much I pay, $1,891. And what is yes? Mail order. Oh. Well, but I don't have to go mail order. But what is this deductible, $108 deductible, on what?

ROVNER: Pharmacist Schaeffer agreed that the process isn't easy.

Mr. SCHAEFFER: There are so many configurations of these plans, the way they pay, the co-pays they charge, the amount of time it takes you to get in and out of the initial period. Some of them pay through the initial period, some of them don't. I mean, it's amazing. I mean...

ROVNER: Two and a half hours later, Mom and I had pretty much the same list of plans I came up with on my own. And still no final decision. So I went looking for someone who offers counseling one on one.

Ms. SUZANNE JACKSON (Director, Health Insurance Counseling Project): Good. OK. Sounds good. Could I get your ZIP code? OK. Very good.

ROVNER: Suzanne Jackson is the director of the Health Insurance Counseling Project at George Washington University Law School. The project is the designated Medicare insurance counseling program for the District of Columbia. There's one for every state. Normally, Jackson says, the three lawyers and eight volunteers field about 150 calls a month from people with health insurance problems.

Ms. JACKSON: And in late November we were receiving about 150 calls a day.

ROVNER: That's left them with a pretty big backlog.

Ms. JACKSON: We're making significant progress. We have lots of volunteers coming in on Saturdays and on evenings and we're dedicating almost all of our time to returning these calls. But it's going to be a tight squeeze to get everybody's call returned before the end of the year.

ROVNER: Today Jackson's calling back a woman who asked for help several days ago.

Ms. JACKSON: I ran your drugs through the computer and it sounds like--or it looks like there's one plan that covers your drugs with--it's got a few quantity limits on them but no serious limitations.

ROVNER: The woman agrees that the plan sounds like a good one for her, even though she'll actually pay a bit more per month than she does right now. And Jackson goes ahead and enrolls her.

Ms. JACKSON: OK, you're in. I'm going to mail you the confirmation number and it'll also have the phone number--but let me give you that phone number now.

ROVNER: This call only took about 10 minutes, but Jackson said she'd already spent about an hour and a half getting the woman's drug list from her pharmacy and checking it against the various Medicare databases. She says that's about average and she does this for a living. I guess I know what I'll be doing over the long holiday weekend. Julie Rovner, NPR News, Washington.

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