Medicare drug benefit begins; experts say study up before enrolling

Published 12:00 am Tuesday, November 15, 2005

Natchez &8212; For the 42 million Americans who may be considering signing up for the Medicare prescription drug benefit today, the best advice may be, &8220;Don&8217;t move too fast.&8221;

Today is the first day Medicare-eligible seniors may sign up with one of the more than 100 programs available throughout the United States.

&8220;The first thing I would say is don&8217;t panic,&8221; said Fred Parker, a Natchez insurance agent who has waded through dozens of programs for clients. &8220;It&8217;s so complicated.&8221;

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Sign-up continues through May 15, and those who have not done their homework should do so before choosing a plan, Parker said.

And important to know for those who are Medicare eligible and still employed: If your company insurance covers prescription drugs, be sure it meets Medicare criteria; it if does, you will not be penalized for not enrolling in Medicare drug coverage until you retire.

Chick Graning of the Natchez AFLAC insurance office and a Mutual of Omaha representative who also sells Medicare supplementary insurance and prescription drug insurance programs, said it is crucial for seniors to make decisions based on their individual needs.

&8220;There are dozens and dozens and dozens of plans,&8221; Graning said. &8220;And you do not have to stay with the company where you have your Medicare supplement.&8221;

The Medicare supplement is insurance that picks up where Medicare leaves off, called the F plan, sold through many insurance companies and by law offering exactly the same thing &8212; paying anything Medicare doesn&8217;t pay in full.

The drug prescription plan is an entirely new program, passed by Congress in 2003.

The prescription drug plans all are privately run but approved by the government, Graning said. And they are all different.

Sabrena Bartley, executive director of the Natchez Senior Citizens Center, said she and her staff are working one-on-one with seniors to help them understand the prescription plans available.

The plans vary widely in costs, some less than $10 a month and others up to $70 or more, Bartley said.

&8220;Every day we make calls for people and go online for some of them,&8221; she said. &8220;One of the major problems is that people can&8217;t navigate the phone system or the Internet.&8221;

To receive prescription drug benefits beginning in January, seniors must sign up for a program by Dec. 31. The last day in 2006 to sign up for receiving benefits in 2006 is May 15.

Penalties for signing up after the May 15 deadline will add a 1 percent penalty for every month a person delays enrolling in a plan.

After May 15, the next opportunity to enroll in a prescription drug plan will be Nov. 14 through Dec. 31, 2006.

In checking out each plan, a senior should look at what it costs, what drugs it covers and what percentage of the payment of prescriptions it covers, for example.

&8220;You have to ask what drugs the plan covers, what drugs it does not cover,&8221; Graning said. &8220;For example, a company may cover Lipitor but not Crestor for lowering cholesterol.&8221;

The senior should project his or her drug costs over the next year, Graning said.

&8220;Pick and choose the plan according to the needs you have. Find the companies. Call them. Ask them what they offer.&8221;

The official Medicare web site has good information and provides a way for the Internet-savvy person to make comparisons of prescription plans at www.medicare.gov.

And for those who are not Internet-savvy? &8220;Find someone who is,&8221; Graning said.

Cheaper plans may be fine for some Medicare recipients but not for those who take numerous, expensive prescription drugs.

&8220;Usually the cheaper plans do not cover all the drugs,&8221; Graning said. &8220;And you have to ask to what degree the plan covers the drugs. Is it 10 percent? You need to know. Be very specific in your questions.&8221;

Bartley said people who are unable to sift through the pages and pages of material become confused and frightened.

&8220;We can help people to compare plans,&8221; she said. &8220;We can provide copies of the comparisons for those who want to come by to pick them up here.&8221;

Another important consideration is a person&8217;s pharmacy of choice, Parker said. &8220;Be sure the druggist you prefer will accept the plan you choose,&8221; he said.

Parker also said people should know that they will not be locked into a program for the rest of their lives when they enroll in coming months. &8220;Every year during an open enrollment period, you can switch to another plan if you choose,&8221; he said.