Undecided About Medicare Drug Benefit

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Federal health officials laud Medicare’s prescription drug benefit as the beginning of a new era.

At a press conference last week, Health and Human Services Secretary Mick Leavitt said Medicare beneficiaries have long awaited the day to get drug coverage.

Leavitt: For the first time ever Medicare will offer every beneficiary the peace of mind of knowing that their prescription drug needs will be met and that they’ll be met at prices they can afford and plans that meet their needs everywhere in the country.

Not everyone is convinced.

In a poll released this month from the Kaiser Family Foundation and the Harvard School of Public Health, forty three percent of seniors can’t decide whether the Medicare drug benefit is right for them.

Hart: For me it’s hard cause I’m not on anything.

Bob Hart is in that undecided camp.

Hart is a healthy, sixty seven year old retiree from Lee who says he hasn’t needed a prescription in three years.

He has come to Durham to attend a Medicare Part D informational session put on by the state’s Bureau for Elderly and Adult Services.

[sounds lecturer about Medicare D: The question is: What if you don’t take any prescriptions…]

Hart wants to know whether buying a plan makes financial sense.

The cheapest one starts at twenty dollars a month.

Hart: Over several years that would add up. So if I went three or four years before I needed a prescription I’d save a lot of money, I’d have that as a nest egg.

Hart isn’t alone.

The Bureau’s Kim Hadank-Swinson says she gets a lot of questions from people in Hart’s situation.

Hadank-Swinson: I explain that it’s an insurance like any other insurance, like homeowners insurance. Like car insurance you pay a premium, you pay a deductible and hope that nothing happens. Well it’s a similar situation.

It’s insurance, but with a little added pressure.

If people who are eligible don’t sign up by May fifteenth two thousand six, a small fee is added to each month’s premium if they do decide to sign up.

And after open enrollment ends in May, the next sign up period isn’t until November.

It’s details like these that make the decision tough for Bob Hart.

But Mark McClellan, the Administrator for the Centers for Medicare and Medicaid Services said the benefit is a great deal for people who don’t have coverage.

McClellan: People with Medicare owe it to themselves to look into this new benefit. It’s worth it. Even if you have no, low costs now, think about the future and the peace of mind you can get from having prescription drug coverage.

And for those who do have drug costs, McClellan says they will save fifty to seventy percent by getting a plan.

But there are thousands of people with low incomes in New Hampshire who get free drugs from pharmaceutical companies.

Even so, Bernie Cameron says many will be looking into buying a plan.

She runs Medication Bridge, which helps people with low incomes find free drugs.

Cameron: A lot of the drug companies now are starting to say, you’re going to be eligible for Medicare Part D so we’re no longer going to give you your meds free.

Cameron says the very poor will continue to be taken care of through Medicare assistance.

But anyone making between eighteen and twenty four thousand a year is left in a bind.

Their income qualifies them for free medication through the drug companies, but not for any low income assistance through Medicare.

Cameron says for some individuals, a Medicare drug plan could cost them several thousand dollars a year.

Cameron: They’re trying to decide if they should sign up for Part D, to just kind of be safe. Or if they should take their chance and continue to get whatever meds they can free.

But taking a chance could leave a person without any help getting medication.

Cameron: There’s no guarantee that the pharmaceutical companies will continue their programs so it could happen like next November, say November 2006 a person that’s been getting their meds free from one company could get a letter in the mail saying we are discontinuing our program.

Cameron fears people might chose to forego their medication rather than joining a Medicare plan.

For people in that situation, she can’t offer an easy solution.

And there is a third group of undecideds: those who are simply confused.

But in New Hampshire there is a small army of educators blanketing the state with outreach efforts to get people informed.

Pharmacies have booklets describing plan options and drug companies have launched an extensive marketing campaign.

National polls show that seniors are becoming less confused over the myriad of options the benefit contains.

But even after attending the informational session, reading a dozen booklets, calling pharmaceutical companies, and tapping the Internet, Bob Hart is still undecided.

Hart: Well what I’ve learned is that it’s at least as complex or more so than I thought and that other people are just as at sea as I am. It’s not just me that’s confused.

Hart and tens of thousands of others in the state have until May fifteenth to make up their minds.

SOQ