Washington, D.C. - Today, Medicare beneficiaries can start signing up for the new Medicare prescription drug plan. But first they have to pick the plan that will offer them the best coverage given the drugs they take. Depending on where someone lives, that's making a choice from among at least 27 and up to 52 drug plans. That doesn't include the additional Medicare Advantage Plans, which increase the number of choices significantly.
"It is clear that seniors will have a very difficult time wading through the fine print among dozens of plans," said Ron Pollack, Families USA Executive Director. "Seniors are bewildered by this complex program and, as a result, many will not enroll in the program."
Seniors have to evaluate numerous things before deciding on which plan is best for them. The Centers for Medicare and Medicaid Services (CMS) does have a Plan Finder, an Internet tool to help people sort through their choices, but it is a confusing and complicated tool that has to be used by a population out of which:
* 76 percent of seniors have never been online.
* 26 percent of people in Medicare have cognitive impairments.
* Over 3 million seniors have visual impairments.
* 2.3 million Medicare beneficiaries reside in nursing homes.
Aside from the fact that the prices of drugs in the Plan Finder keep changing from day to day, there are several questions everyone in Medicare should ask when evaluating drug plans. These include questions about costs, such as the size of monthly premiums, annual deductibles, co-payments, gaps in coverage, and a plan's drug prices. For example, the monthly premium is different for each plan in the Maryland/DC region, with monthly premiums ranging from $6.44 to $68.91. Deductibles range from $0 to $250 in 2006. Seniors also need to know what drugs are covered and what pharmacies they can go to under each plan.
Add to this an entirely different process for those who are eligible for added low-income help. Applying for low-income help is a separate process that is in addition to picking a plan.
Multiply all these choices by the number of plans in each area, and the complexity of this program as it was devised becomes clear. Making the best choice is a process that could challenge anyone.
"All of this confusion and complexity could have been avoided from the start if Congress and the President had not caved in to the pressure of the drug lobby," said Pollack. "They prohibited Medicare from bargaining for cheaper prices and, to ensure that this would never change, they delegated the administration of the benefit to private plans, which have far less bargaining clout.
"In the end, this problem will not be resolved by CMS or the Plan Finder. The best way to remedy these problems is to allow Medicare to administer the benefit and to directly negotiate for better prices with the drug companies."
For more information: Comparison Chart l Evaluating Drug Plans l Glossary of Terms l Plan Finder Game: An Illustration
