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Seniors' Rx plan assists, annoys

A year later, Medicare drug program still complicated

Date published: 2/18/2007

BY DONYA ARIAS

The federal prescription drug program available to all Americans ages 65 and older is a rousing success or a nightmare, depending on whom you ask.

Medicare Part D, which began offering prescription drug coverage to seniors on Jan. 1, 2006, now covers more than 22 million people, or just more than half of all those eligible.

While overall satisfaction with the program is high, even its staunchest supporters say such a sweeping program is bound to have its kinks. Locally, many enrollees are frustrated at premium hikes and bureaucratic red tape as the program enters its second year.

"It has its pros and cons," said Hugh Patrick, 76, of Fredericksburg.

Patrick was surprised to learn that his injectable medication, which last year had been covered by the Medicare outpatient program, was suddenly switched to Part D. The result: His out-of-pocket charges went from zero to $265 weekly.

"I still have significant issues with Medicare Part D," said Valerie Hopson-Bell, elder-rights advocate for the Rappahannock Area Agency on Aging. "I do not believe it is a benefit to all the people it serves."

Federal officials have been applauding the program's successes since the beginning of the year, pointing to four consumer surveys that found satisfaction rates ranking from 75 percent to 85 percent.

"By every measure, it has been a strong success," said Jeff Nelligan, spokesman for the Centers for Medicare & Medicaid Services in Washington.

Nelligan said program costs are lower than expected, with the average consumer's monthly premium at $22.

"Beneficiaries are saving an average of $1,200 a year on prescription drugs," he said.

As Congress crafted the plan in 2005, critics charged that insurance companies would not sign on, and Medicare beneficiaries would not sign up. Both criticisms have turned out to be wrong. But some now say too many companies are offering Part D drug coverage, creating confusion. This year in Virginia, 14 companies are offering a choice of 53 drug plans, according to an analysis by the Kaiser Family Foundation.

While her phone isn't ringing off the hook as it was when the drug program launched, Hopson-Bell hears, as she visits local senior centers, that people are afraid to change plans.

Medicare is a federal health insurance program for people 65 and older, younger people with certain disabilities, and people with permanent kidney failure. Those eligible for Medicare can enroll in the program's Part D prescription drug coverage. Here's how Part D works: Dozens of different plans, all run by private insurance companies, are offered. Participants decide which plan to join and generally pay monthly premiums, annual deductibles and co-payments for their drugs. Costs vary by plan and income level. For more information, see medicare.gov or call 800/772-1213.

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Date published: 2/18/2007