Seniors try to decipher drug options
11/6/2005Bob Cain speaks for many senior citizens when the subject is Medicare's new prescription drug plan.
"It's confusing," he said as he stood outside a senior center in Toledo's Uptown neighborhood. "I got the big book [from Medicare], and I looked on the Internet. But I'm a college graduate, and I couldn't understand it."
Over and over, in senior centers, nursing homes, assisted-living complexes, and around kitchen tables nationwide, senior citizens and their family members are trying to make sense of Medicare's drug plan.
It hasn't been pretty.
"I don't think I've met any seniors who are [happy] with it," said Julie Dangelo, executive director of Senior Centers Inc., the senior center where Mr. Cain frequents. "Everybody is confused."
That said, Ms. Dangelo and other senior advocates have a message for the 43 million Americans on Medicare: Yes, this is confusing, and you are certainly free to complain about it. But ready or not, the clock on the decision-making process will begin ticking Nov. 15.
By May 15, seniors will have to decide whether to sign up for Medicare's drug program. If they participate, they must determine which drug-plan option is best for them.
Despite all the hassle, the federal government expects seniors who take part in the program could end up saving quite a bit on their prescription-drug costs. Those with low income or on Medicaid likely will have all or most of their drug costs covered by Medicare - above and beyond the standard financial help available through the new program.
In an effort to alleviate confusion for seniors and their family members facing this important decision, The Blade has gone to experts and senior advocates to answer some basic questions.
So, what should you do first? Relax.
"You don't need to make a decision right now. There's no rush," said Kathy Keller, a spokesman for AARP Ohio. "Don't jump and say, 'It's Nov. 15 and I have to make a decision.' Collect all the information, and get your questions answered before doing anything."
The deadline for taking action and picking a plan is not Nov. 15 but May 15. However, seniors who wait until after May 15 likely will face penalties and have to pay higher premiums and other costs.
The first thing seniors need to decide is whether they should even join a Medicare prescription-drug plan. If seniors get their drug benefits through a retirement plan from their union or former employer, they already might be receiving a better deal than what Medicare will provide. By law, those former employers or unions have to send a letter telling seniors whether that's the case. Veterans eligible to receive drug benefits through the Department of Veterans Affairs get a better deal through the VA, for example, so they should stick with that.
If Medicare's drug plan does sound like it might be a good option, the most important thing seniors will need to have available when picking a plan - or when talking to someone who will be assisting in selecting a plan - is a list of all the drugs they are taking, the dosage amounts, and how often they take the drug. That's a list that doctors say seniors should have handy whether they choose to go with a Medicare drug plan or not.
Another key piece of information for seniors to know is whether they qualify for extra financial assistance. The Medicare drug program, in its standard form, doesn't cover all expenses. However, for many low-income seniors, including those on Medicaid, there is extra financial help available. Medicaid recipients automatically qualify.
Those not on Medicaid will need to apply for the help, which is available to those making less than $14,355 annually ($19,245 as a couple). The Social Security Administration handles applications, and seniors can call 1-800-772-1213 to learn if they qualify.
And remember, there are many people and places with resources available to help seniors in need of help in making these decisions. Use them. While insurance companies will have a vested interest in the plans that seniors choose, area senior centers and many pharmacies and doctors offices are offering assistance, and there's a host of toll-free phone numbers available.
Perhaps the best advice for seniors right now: Take your time in making a decision.