NorthJersey.com

Dial 'D' For Disaster

The Record / NorthJersey.com — Wednesday, May 10, 2006

For many seniors and disabled people who have yet to choose a Medicare prescription-drug plan, Part D-Day is rapidly approaching. And the obstinate refusal of Medicare administrators to extend next Monday's enrollment deadline is infuriating.

It's not that Part D is devoid of merit. Many of the people who have signed up for a plan are seeing a reduction in prescription costs. But the federal government created a system rife with confusion – so much so that many of those who did sign up were unable to do so without hours of help from a family member.

And now that time is running out, administrators are blaming the seniors for procrastinating while the bureaucrats make it even more difficult to obtain information about the array of plans. In New Jersey alone, 19 providers offer 45 different plans.

Radio ads blare that people should just visit the Web site medicare.gov or call the hot line, (800) MEDICARE. But not all seniors are computer-savvy, and the hot line is a maze of pre-recorded messages requiring a caller to wade through a litany of options before reaching a customer service representative.

To make matters worse, investigators from the Government Accountability Office reportedly placed 500 calls to the toll-free number and found that one-third resulted in faulty information or none at all.

Consider, for example, the penalty for missing Monday's enrollment deadline.

We visited the Web site, and selected the frequently asked question: "What happens if I choose not to join a Medicare drug plan by May 15, 2006? Can I join later?"

"Answer: If you don't join a plan by May 15, 2006, and you don't currently have a drug plan that, on average, covers at least as much as standard Medicare prescription drug coverage, you will have to wait until November 15, 2006 to join. When you do join, your premium cost will go up at least one percent per month for every month that you wait. ...

"If you join after May 15, 2006, the next open enrollment period [begins] November 15. ..."

OK, say a senior decides to enroll on May 16, but has to wait until Nov. 15. Will the penalty be 1 percent or 6 percent, and will it be permanent? Neither the Web site nor the hot line has an answer to that.

Furthermore, New Jerseyans who need the benefit the most – low-income senior citizens – are those least served by Part D, according to a
report released yesterday by New Jersey Citizen Action. No wonder the non-profit group wants the deadline extended while the system is fixed.

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Barring a last-minute reprieve, what's a grandmother to do?

For one thing, organizations that run programs for seniors all are available to answer questions and offer guidance through the maze. For another, pharmacists can offer advice about which drugs are covered under which plans.

Seniors who don't use many medicines might be tempted to skip the May 15 enrollment deadline – but they should enroll now anyway. Down the road they might need more prescriptions. If they enroll now in a low-cost plan, they can switch plans later with no penalty. If they wait two years and then sign up, the penalty would jack up their premiums by about 24 percent.

It's incumbent on anyone who might benefit from Part D to seek help – be it from a relative, a pharmacist, a plan sponsor or an advocacy group. A backlog in processing last-minute applications is likely to delay the start of benefits, but at least you'll avoid paying a higher premium for the rest of your life.

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