Look before leaping into Medicare plan | The Honolulu Advertiser

Comment, blog & share photos

Look before leaping into Medicare plan | The Honolulu Advertiser | Hawaii's Newspaper

Posted on: Sunday, November 20, 2005

Look before leaping into Medicare plan

MEDICARE HELP AVAILABLE

Here are some resources to aid in the research process:

• Medicare (www.medicare.gov) includes several helpful search tools, reachable from the home page, including a “formulary finder” that sorts the plans by state and prescription medications that they cover. The “Landscape of Local Plans” gives overview information that’s important to understand.

• The Medicare Rx Education Network (www.medicarerxedu cation.org) provides further detail and serves as a link to other helpful resources.

• “Medicare Rx: A National Conversation” is a 30-minute town-hall style program on the prescription drug benefit that will air at 1:30 p.m. today on the CNBC cable network.

Seniors and others who are contemplating which of the dizzying array of Medicare drug plans to choose, follow this piece of advice, if nothing else: Take the time to do your homework.

For weeks, that's been the counsel of the Medicare Rx Education Network, a coalition of organizations serving seniors and others who are eligible for the new Medicare drug coverage. And even though the six-month signup period has been under way officially for more than a week, it's still wise to take a deep breath and study your options before jumping into the deep end.

Sage Plus, the program under the state's Executive Office on Aging to aid with health insurance issues, is reporting that folks have been confused by the choices — even when using Medicare's Internet search tools designed to winnow the list of plan selections to a manageable number, depending on which drugs are being used.

THE 'DOUGHNUT HOLE'

The problem is that some people enter their prescription drugs into the search engine without realizing that some of the plans have gaps in the coverage — a characteristic called the "doughnut hole." This means that some plans will cover drugs up to a certain annual spending limit. Coverage then drops off and doesn't kick back in until spending passes an even higher mark.

An applicant who doesn't understand the coverage gap may compare plans based on a monthly cost, when the annual cost may be a more accurate basis for comparison.

Confused yet?

Despite the best efforts of Medicare and supporting agencies like Sage Plus, many, many senior citizens nationwide remain confused.

Roughly 43 million people are eligible for the new benefit. On average, each has at least 40 plans to pick from. From a cost-saving standpoint, this is wonderful. But the array of choices is understandably frustrating.

The online tools (see box below) are still the best helpers available, but many seniors are uncomfortable going online. Even for those who consider themselves Web-savvy, the process can be confusing.

Seniors have basically three routes for seeking help:

A family member can help them sort through the pile of brochures sent by mail or navigate through the Web search. There may be a higher comfort level here, but relatives had better start up the learning curve soon and leave time to seek an external assist, if need be.

Anyone can call (800) MEDICARE for around-the-clock advice, but this may not appeal to someone who prefers a face-to-face interview.

Such interviews can be arranged through Sage Plus, 586-7299 on O'ahu or (888) 875-9229 (toll-free from the Neighbor Islands or Mainland). But this requires that a questionnaire listing medications and other personal information be completed first.

Although there are advantages to making an early selection — the option to change your mind becomes more limited after the end of the year — the final lock-in date doesn't arrive until May 15, 2006.

Given that there are financial penalties for jumping tracks further down the road, this is a decision that it's best not to rush.

Sponsored by:

Comment, blog & share photos