Seniors sort out Medicare drug program

5/2/2006
BY JIM SIELICKI
BLADE STAFF WRITER
  • Seniors-sort-out-Medicare-drug-program-2

    Steve Kemper of Bellevue takes notes during the Medicare meeting.

  • Sonja Runion of Tiffin is trying to find a drug insurance plan that covers the $1,273 monthly cost of her psoriasis medicine. Sitting next to her is her husband, Edward.
    Sonja Runion of Tiffin is trying to find a drug insurance plan that covers the $1,273 monthly cost of her psoriasis medicine. Sitting next to her is her husband, Edward.

    TIFFIN - Sonja Runion is afraid she's fallen into a Medicare black hole trying to sign up for the program's new prescription drug benefit.

    The Tiffin woman attended one of three forums yesterday with Joan Zimmerly, a representative from the Social Security Administration's Lima, Ohio, office who explained the inaugural drug plan and the need to sign up before the May 15 deadline.

    Mrs. Runion, 67, and her husband, Edward, 75, attended the session at the Seneca County Commission on Aging in Tiffin, sponsored by U.S. Rep. Paul Gillmor (R., Old Fort).

    Mrs. Runion said despite 44 insurance plans to choose from, she's been unable to find an insurance company that will cover the $1,273 a month cost of the medicine for her psoriasis.

    Until the program began, she'd been receiving financial help through the manufacturer. Now she's ineligible for further aid, she said.

    Steve Kemper of Bellevue takes notes during the Medicare meeting.
    Steve Kemper of Bellevue takes notes during the Medicare meeting.

    The forum failed to provide much enlightenment, she said afterward - "not for my situation," she said.

    If she does find a drug plan that covers her psoriasis medicine, she fears she'll soon fall into the so-called "doughnut hole." That's the part of the program in which consumers pay up to $2,250 of their drugs' costs. The "doughnut" provision then eliminates any coverage until the claims reach $5,100, after which the program kicks in again.

    Ms. Zimmerly told the nearly two dozen people at the Somerset Reception Center east of town that extra help is available in choosing a plan, while warning that she "can't endorse one plan over another."

    She encouraged the seniors to run the program available on the agency's Web site www.medicare.gov, which helps people compare drug plans. She also urged seniors to call 1-800-633-4227 for assistance.

    The session also was of little help to Alton Raudebaugh, 87, of Tiffin, who attended the forum with his daughter Becky Comer.

    "I'm still confused," he said.

    The Medicare drug plan, however, will supply some relief for his medicine bills once he picks a plan. He retired in 1977 after 37 years with American Standard Co. in Tiffin. During that time, he had no medical insurance, he said.

    Ms. Comer said she was pleased with the information provided. "It gave us a little insight into what to do," she said.

    Still, the wide variety of insurance companies from which to choose confused the issue, he said.

    "I wish Social Security would take it all over," he said.

    Mr. Gillmor, who attended the sessions in Tiffin, Upper Sandusky, and Bowling Green, said after the Tiffin session that he was pleased with the turnout.

    "I think there is some confusion," he said. "But 65,000 people [in the 5th Congressional District] have signed up for coverage. The message is getting out."

    He said the number represents more than two-thirds of the eligible people.

    "Once they sign up, they're happy," Mr. Gillmor said.

    But he warned that seniors could miss out on savings for the drug costs if they fail to act.

    If eligible seniors wait beyond May 15, they'll pay a penalty when they do join. People who sign up later probably will have to pay higher premiums.

    Some members of Congress have proposed extending the deadline past May 15.

    Medicare says its drug coverage is insurance that covers brand-name and generic prescription drugs to offer protection for people who have very high drug costs. Everyone with Medicare is eligible, regardless of income and resources or health status, the agency says.

    Monthly premiums vary by plan, but are capped at $250 a month and involve a co-payment. Ms. Zimmerly said people with limited income and resources may qualify for extra help so they wouldn't have to pay a premium or deductible.

    Contact: Jim Sielicki at:

    jsielicki@theblade.com

    or 419-724-6078.