admin @ Tue, 2005-10-25 06:46
CLAIM program manager Carol Beahan says although there isn't enough information for Medicare beneficiaries to choose a prescription drug plan, there is plenty of preliminary work they can do on their own.
Beahan advises people with Medicare who already have prescription drug coverage through another company, employer or union to examine how their coverage compares to plans with the new Medicare drug benefit.
“If you have a drug plan that's equal to or better than a Medicare plan, you may not need to enroll,” she said.
Those who have prescription drug plans should receive letters from their providers explaining whether they cover as much or more than Medicare requires.
Medicare beneficiaries should also make a list of drugs they need, identify their preferred pharmacy and apply for financial assistance, Beahan said.
CLAIM counselors will help people find prescription drug plans instead of using the Medicare online tools.
“We know our lines are busy, but we return all phone calls,” she said.
Jefferson City — Medicare officials have designed a handful of online tools to allow people to search for and compare the first-ever prescription drug plans under the federal insurance program. But despite a promised mid-October unveiling, some are still incomplete.
In less than a month, more than 800,000 elderly and disabled Missourians will have the option to enroll in a prescription drug plan under the federal health insurance program. Many are eager to choose a plan, but the decision means wading through a slew of information and waiting for more.
In Missouri, 15 private insurance companies will offer one or more prescription drug plans under Medicare Part D. Premiums, deductibles and co-payments will vary by insurer, while each plan will cover specific drugs through certain pharmacies.
An online device that would allow users to search for plans in their area based on what drugs they need and what pharmacy they prefer is not fully available. When it is, Medicare officials say the Prescription Drug Plan Finder will also calculate how much each plan would cost.
At CLAIM, a Columbia-based organization that offers free Medicare help, counselors hoped the tools would be uploaded — and fully operational — by Oct. 17.
“There is enough information to get started and narrow the selection, but not enough for people to make decisions about specific plans,” said Carol Beahan, CLAIM program manager.
For now, the Landscape of Local Plans tool lets users look at plans offered in their state and county, and a formulary finder shows which providers will cover specific drugs. Another tool can estimate users' potential savings under Medicare Part D, based on what they pay per month for prescription drugs and what state they live in. These tools are available at the Medicare Web site, www.medicare.gov.
CLAIM counselors are fielding more than 100 phone calls every day, she said.
“It's a good problem,” said Diana Brady, a CLAIM trainer.
Phones are ringing off the hook in the Southwest Missouri Office on Aging, with 150 to 250 calls daily, said resource development director Andrea Porter.
Parker said it was too bad the online tools are not all available.
Julie Brookhart, a spokeswoman for the Kansas City regional office of the federal agency that runs Medicare, attributed the Web site delays to some deadline extensions.
Employers and unions that offer health insurance now have until Oct. 31 to decide whether they will maintain prescription drug coverage. If they do, they can apply for federal subsidies that will allow them to be more competitive with plans that carry the Medicare drug benefit.
Brookhart also said there's no need to rush, emphasizing Medicare's six-month enrollment period.
“They have from Nov. 15 to May 15 to enroll,” she said.
But the sooner beneficiaries enroll, the sooner they get coverage. Those who enroll by Dec. 31 will receive coverage beginning Jan. 1. After December, those who enroll will get coverage at the start of the following month. Those who do not meet the May enrollment deadline will have to pay higher monthly premiums, unless they currently have prescription drug coverage that measures up to Part D standards.
Medicare administrators have guaranteed that all of the online tools will be fully functioning when Medicare enrollment opens on Nov. 15.
“We can only hope that it is in a timely manner, and so on,” Porter said.
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