Retirement News : Seniors : Selling seniors on drug benefit

Selling seniors on drug benefit

Date Added: 15-07-2005

COLONIE Officials like Bush Cabinet member Mike Leavitt must respond to the concerns of seniors like Joan Markes of Colonie if the new Medicare drug program is going to get off the ground.
"Everything that has been put out so far is totally confusing," said Markes, 67, as she and a couple of hundred other seniors waited for Leavitt to hold a town meeting on Thursday at the Beltrone Living Center.

The new drug benefit will help pay for prescription drugs for the 41 million people now enrolled in Medicare, the federal health insurance program for the disabled and people 65 or over. For low-income recipients, Medicare will pick up virtually the whole tab.

Secretary of Health and Human Services Leavitt joined Gov. George Pataki and local officials at a stop on a national tour designed to encourage seniors to sign up for the new drug plan. They can begin enrolling Nov. 15. The program will start paying for medications Jan. 1.

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 created the new plan the first drug help ever through Medicare. It is complex. Most enrollees will pay a monthly premium of $35 and a $250 deductible. Medicare will pay 75 percent of drug costs, up to a limit of $2,250.

At that point, seniors in the program must pay all of their prescription costs until they reach a "catastrophic" annual cost of $5,100. Then, the feds kick in again, paying 95 percent of all additional costs. The range between $2,250 and $5,100, where seniors pay all costs, has become known as the "doughnut hole."

None of those parameters are set in stone: Seniors will actually choose among a dozen or more private plans, each with its own premium, deductible, doughnut hole and list of drugs that will be covered.

The work of helping seniors pick the plan that's right for them is likely to fall to local groups, senior centers and county agencies. Some groups worry about the burden that new work will place on their staff.

"People will need a lot of one-to-one assistance," said Lani Sanjek, associate director of Statewide Senior Action of New York. "We're not at all clear that there will be sufficient capacity to provide the level of individual counseling that people need."

ROUSE RPC, a East Greenbush nonprofit, runs 225 apartments for seniors. It has one woman who works two days a week helping seniors with benefits and other issues, according to Executive Director Marlene Papa.

"All this work will fall to her," said Papa. "She's going to be overwhelmed."

In an interview with the Times Union, Leavitt said he is looking to families and the institutions that support seniors for help in encouraging them to join and interpret the new benefits.

"How are we going to reach 41 million?" he asked. "We won't have a chance to do it well without neighborhoods, community centers, churches, pharmacies and clinics."

Some local groups report that they're already preparing.

"Here in the Capital Region, the county offices of the aging and the nonprofit providers have been gearing up for this," said Philip McCallion, acting executive director of the Elder Network of the Capital Region.

For More Information:

http://www.timesunion.com/aspstories/story.asp?storyID=379472