Deadline Looms For Medicare Patients, Tampa Tribune

April 04, 2006

Tampa Tribune (04.06.06) By Carol Gentry

TAMPA - With a May 15 deadline fast approaching, a big push is on to get more than a million Floridians who qualify for the new Medicare drug benefit enrolled.

Experts worry that only a third of Medicare patients without prescription drug coverage have signed on for the program, called Medicare Part D. In 39 days, enrollment will close for the year, and those who wait until next year will pay a penalty in the form of higher premiums.

"It's in the best interests of all Medicare beneficiaries [without drug coverage] to enroll in Part D," said Charmaine Andrews, volunteer coordinator for the West Central Florida Agency on Aging in Tampa. "It will allow them to save dollars on their prescription drug costs this year and in the future."

Foot draggers say they are stumped by the complex array of plans. In Florida, 19 companies are offering 43 plan options, and in most urban areas there are also dozens of HMO-style Medicare Advantage plans with drug coverage.

"I don't know where to go. I don't know what to do," said Amelia Carroll, 78, of Temple Terrace. "I'm so confused."

She worries that if she enrolls in a drug plan, she will have to give up her doctor. (She won't.) Meanwhile, others eligible for Part D coverage think they can sign up later in the year. (They can't.)

Andrews and other experts say that what Carroll and other seniors need to know is that independent, trustworthy advice is available for free by phone, on the Web and at seminars statewide.

Savings Under Plan Can Add Up

Medicare officials and local counselors say beneficiaries who enroll in drug plans average savings of 50 percent compared with their prior spending on prescriptions. In a report released this week, Health and Human Services Secretary Mike Leavitt said the plans saved enrollees an average of $1,100 a year.

The reason most beneficiaries save money on the Part D drug benefit is that a government payment covers about 75 percent of the premium.

Those who become eligible for Medicare after May 15 won't have to pay a penalty for enrolling late, according to the rules. But those who are eligible and don't enroll by May 15 will be shut out of coverage for the rest of the year.

If they decide to enroll in 2007, they will have to pay a penalty on premiums of at least 7 percent, Andrews said. The program was set up that way to encourage beneficiaries to enroll early, before they develop new or additional health problems.

Most who have signed up are happy they did, according to a survey sponsored by the Medicare Rx Education Network, a coalition of health groups. The survey, conducted in March, found 87 percent of those who voluntarily enrolled in a stand-alone prescription plan - in other words, one that covers just drugs, not doctor or hospital bills - said the benefit worked well. More than three-fourths said it gave them peace of mind to have prescription coverage.

Not all enrollees are happy with the program. They include:

Former Medicaid beneficiaries, who used to get drugs for free but under Part D pay up to $5 per prescription.

Those enrolled in prescription assistance programs offered by some drug manufacturers at little or no cost.

Seniors who fall into the so-called "doughnut hole," a coverage gap that begins when the total prescription spending for the year by plan and patient combined hits $2,250 and lasts until the patient has spent $3,600.

Some companies think eligible Part D beneficiaries will become galvanized as the deadline approaches. They are adding staff and phone lines to handle the anticipated flood.

Humana Inc., Florida's largest Medicare provider, has been "hiring as fast as we can," said Scott Latimer, Humana's Central and North Florida market president.

Much of the new hiring has been in Tampa, site of two of the company's five U.S. call centers. Early this year the company added 26,000 square feet at its Hillsborough Avenue call center campus, spokeswoman Barbara Kerr said, and increased the number of customer service agents in Tampa from 200 to 360.

Health plans' need for call center employees has grown in part because potential and new enrollees tend to ask a lot of questions.

To make it easier to select an appropriate plan this year, My Medicare Matters, an independent nonprofit group, is offering one-on-one counseling at events in the Bay area.

Medicare specialist Juliette Cubanski of the Kaiser Family Foundation said she hopes fence sitters will enroll, especially those with moderate incomes and medical needs.

"If these people are not enrolling, it really would be a tragedy," she said.

About 500,000 Gain Coverage

About half of Florida's 3 million Medicare beneficiaries had some kind of prescription drug coverage before Part D went into effect Jan. 1, Cubanski said. About 500,000 of those who didn't have coverage have gained it since enrollment in Part D began in mid-November. Most of those - 380,000 - signed up for drug plans, and the others are in HMO-style plans that cover doctor and hospital care as well as prescriptions.

Enrollment should pick up toward the end of April, predicted Sue Samson, associate planner for the Area Agency on Aging of Pasco-Pinellas.

"As people begin looking at it, they'll say, 'Oh, boy, I really need to make that choice,'" she said.

Even those who think Part D is flawed, such as the Florida Consumer Action Network, concede that most Medicare beneficiaries should enroll in the benefit for their own good.

Phil Compton, program director for the consumer group, said he has been trying to persuade his mother, a retired librarian in Greenville, S.C., to enroll.

"She got the application, but it's too confusing for her," he said. "I've been saying, 'Mom, send me the forms and we'll go through this together.'"