Discounted Drug Coverage- Confusing Even To Those Explaining It

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Comments?

Misty L. Trepke

http://www..com

 

" Even the person who came to explain it to us didn't

understand it. "

 

 

If a program was designed to confuse, misrepresent, and appear to

help when it doesn't, then with results like this, the program would

have to be qualified as a success....

 

-------------------------

 

QUOTATION OF THE DAY

 

" Even the person who came to explain it to us didn't understand it. "

MARY SHEN, 77, on the government's new drug discount program.

 

 

________________

 

http://www.nytimes.com/2004/05/12/national/12medicare.html?th

May 12, 200473 Options for Medicare Plan Fuel Chaos, Not

Prescriptions

By JOHN LELAND

 

 

When Mildred Fruhling and her husband lost their prescription drug

coverage in 2001, they suddenly faced drug bills of $7,000 a year.

Mrs. Fruhling, now 76, began scrambling to find discounts on the

Internet, by mail order, from Canada and through free samples from

her doctors.

 

" It's the only way I can continue to have some ease in my

retirement, " she said.

 

Last week, when the federal government rolled out a new discount

drug program, Mrs. Fruhling studied her options with the same

thoroughness. What she found, she said, was confusion: 73 competing

drug discount cards, each providing different savings on different

medications, and all subject to change.

 

" I personally feel I can do better on my own, " she said. But she

added, " At this point, I don't think anyone can make an evaluation. "

 

Even before they go into effect on June 1, the cards — which are

approved by Medicare but offered by various companies and

organizations — have been the subject of heated political debate, an

AARP advertising campaign about how confusing they are and anxious

speculation from those they are supposed to help. Among retirees of

different income groups interviewed last week, the initial reaction

was incomprehension.

 

" Even the person who came to explain it to us didn't understand it, "

said Mary Shen, 77, at the Whittaker Senior Center on Manhattan's

Lower East Side. " It's not fair to expect seniors, who have enough

difficulties already, to have to figure this out. "

 

Shirley Brauner, 75, pushed a metal walker through the center's

lunchroom. " All I've got to say is they confuse the elderly,

including me, " she said. " I'm furious. They're taking advantage of

the seniors. How can

the seniors understand it? "

 

The prescription drug discount cards are a prelude to the Medicare

Prescription Drug, Improvement and Modernization Act, which will

provide broad drug coverage starting in 2006. The federal government

projects that 7.3 million of Medicare's 41 million participants will

sign up for the cards.

 

Those who wish to do so, however, face the daunting task of choosing

the right card.

 

" What it's like is a bunch of confusion, " said Katharine Roberts,

77, who said she had not been to a movie in six years, in part

because of her drug expenses. " You might find you really need three

cards, and you can only choose one. "

 

The cards are a 19-month stopgap measure to provide discounts of 10

percent to 25 percent for Medicare participants who have no other

prescription drug coverage. In addition, low-income participants are

eligible for subsidies of $600 a year.

 

The Department of Health and Human Services approved 28 companies or

organizations to issue cards; among them are AARP, insurance

companies and health maintenance organizations. Cards cost up to $30

a year. Each card provides different discounts on different drugs,

and is accepted by different pharmacies. Participants can choose

only one.

 

To help people sort through the options, Medicare and a company

called DestinationRx set up a database on its Web site,

medicare.gov, that lists the prices charged under various plans for

whatever medications a user types in. People can get similar help by

telephone at 1-800-MEDICAR. But some providers complained that the

prices on the site were inaccurate, and some cards are not listed at

all.

 

For many retirees, it is too much.

 

" I'm 85, do I have to go through this nonsense? " asked Florence

Daniels, a retired engineer who said she received less than $1,000 a

month from Social Security, of which she paid $179 a month for

supplemental medical insurance. She gets drugs through a New York

State program, which provides any prescription for $20 or less. To

make ends meet and afford her drugs, she said she bought used

clothing and put off buying new glasses. Some of her friends travel

by bus to Canada to buy drugs; others do without, she said.

 

Ms. Daniels did not use the government Web site to compare drug

cards, in part because she cannot afford a computer. " I'm trying to

absorb all the information, but it's ridiculous, " she said. " Not

just ridiculous, it's scary. If there was a single card and it was

administered by Medicare, and it got the cost of drugs down -

wonderful, marvelous. But with these cards, the only thing we know

is that we'll have to pay money to other people to administer what

we can get and can't get. "

 

The discount program, which is financed largely by the cards'

sponsors, reflects the Bush administration's desire to open Medicare

to market principles without allowing participants to import drugs

from other countries, which many Democrats favored.

 

Mark B. McClellan, an administrator at the Center for Medicare and

Medicaid Services, said the complexity of the plan encouraged

competition. " We're seeing more plans offering better benefits, " he

said, estimating that people will be able to save 15 percent or more

using the cards.

 

But the complexity of choices will keep many people away from the

program, said Marilyn Moon, director of health at the American

Institutes for Research, a nonprofit research organization in

Washington.

 

Often, the discount provided by the cards is not as good as what

people can get from existing state programs, union plans or consumer

groups, said Robert M. Hayes, president of the Medicare Rights

Center, a nonprofit organization that helps individuals with

Medicare problems.

 

Sydney Bild, 81, a retired doctor in Chicago, compared the discount

cards with the prices he paid ordering his drugs by mail from

Canada. Dr. Bild pays $4,000 to $5,000 a year for five medications.

When he checked the government Web site, he said the best plans were

about 50 percent to 60 percent higher than what he was paying.

 

But Dr. Bild said his main objection to the new plans was that

companies could change prices on drugs, or change the drugs covered.

Medicare requires plans to cover only one drug in each of 209 common

categories. Consumers can change cards only once a year. Committing

to a card is " like love - it's a sometime thing, " Dr. Bild

said. " What if I chose one? They could drop my drugs two weeks

later. "

 

Companies began soliciting customers for their discount drug cards

last week. When the first pamphlets arrived at Beverly Lowy's home

in New York City, Ms. Lowy said, she looked at them carefully. She

does not have drug coverage and last year spent about $3,000 on

prescription drugs. But the more brochures she read, Ms. Lowy said,

the less clear things became.

 

" You really have to be a rocket scientist, " Ms. Lowy, 71, said. " It

takes time, energy, and you don't even save money. I thought, 'This

one is offering this, this one is offering that.' Finally I decided

this isn't for me. "

 

At the Leonard Covello Senior Center in East Harlem, the new cards

seemed opaque. Ramon Velez, 72, a retired taxi driver, said he had

watched AARP advertisements in which people read the dense language

of the federal Medicare bill.

 

" I was laughing at the people in the ads, but it's true, " Mr. Velez

said. " Everyone's confused. "

 

Mr. Velez receives $763 a month from Social Security, and often

skips his psoriasis medication because he cannot afford the $45 co-

payment under his Blue Cross/Blue Shield plan. He wondered if the

new drug cards could save him money.

 

" But it's very confusing, " he said. " I'd go to the Social Security

office to ask about the cards, but I don't think they'd know. "

 

Alejandro Sierra, 67, a retired barber, paced around the center's

pool table. Mr. Sierra takes six medications for diabetes and

complications from cataracts and colon cancer, and sometimes skips a

medication because he cannot afford it.

 

" I'm interested in the cards, " he said. " But I can't figure it out

on the computer, because I can't see. "

 

Carlos Lopez, the director of the center, said the cards had so far

produced little but anxiety. Mr. Lopez asked participants to bring

any applications to him before signing them, and warned them about

people selling phony cards.

 

" They're not nervous, but concerned, " he said. " They feel, why now?

Why do I suddenly need a card for medications? "

 

Copyright 2004 The New York Times Company |

[Guest guest]

I think these prescription drug cards for seniors is ridiculous. You

just can't figure it out. And in a lot of cases, a lot of seniors are

mentally incapable of making a decision like this. My parents are in

that dilemma - I just don't know what to suggest to them. Leave it to

the government to totally confuse us.

 

Carol

 

 

Misty L. Trepke [mistytrepke]

" Even the person who came to explain it to us didn't derstand it. "

If a program was designed to confuse, misrepresent, and appear to

help when it doesn't, then with results like this, the program would

have to be qualified as a success....