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It's a maze, but seniors are finding their way

These senior citizens looked as happy as someone getting a tooth pulled. Welcome to Medicare Part D, our nation's grand expansion into the area of prescription drug coverage.

By HOWARD TROXLER
Published April 22, 2006

Most of the senior citizens on their way into the Gulfport Senior Center Wednesday looked unhappy. Some were grumpy, some nervous. Some clutched loose papers. Others carried neatly arranged files.

They signed up at the reception desk and took a seat in the lobby. Every few minutes a nice young woman called a name, and the next senior shuffled off into the adjoining room, looking as happy as someone getting a tooth pulled.

Welcome to Medicare Part D, our nation's grand expansion into the area of prescription drug coverage.

Across the nation as the May 15 deadline approaches, senior citizens are signing up. The event at Gulfport was one of several in the Tampa Bay area this month.

For our newspaper's full coverage, check out our Web site at http://www.sptimes.com/2005/webspecials05/medicare/ For other sources, see the bottom of this column.

Here is good news. Without exception, every senior I saw on the way out of the Gulfport Senior Center was happy or relieved. I asked each one: "Satisfied customer?" They beamed and gave thumbs up.

"You'll never know what peace of mind I have now," Sharon Kutzli, 69, of St. Pete Beach told me. She had been dreading and putting off the signup for months. "I was so confused." But she was smiling as she drove off.

In no way am I trying to make Medicare Part D sound like all peaches and cream. Some people will be better off. Some will be worse off. Some people won't know until later. Beneath it all, the taxpayers are on the hook big time.

Here's how it works:

You choose a private insurance plan to cover your drugs. There are a confusing number of plans. At Gulfport and other such events, seniors bring in their lists of prescriptions, and counselors use computers to produce a list of suggested plans.

You pay a monthly premium, somewhere around $35. You pay an annual deductible of $250 (you pay that much out of your pocket before any coverage kicks in). You also make a "co-payment" of a few dollars for each prescription.

The reason the seniors I saw in Gulfport seemed happy was that almost all of them were, no offense, "typical" folks who will save money under Part D. Sure, there is paperwork and bureaucracy, but in the end they will be paying less.

On the other hand, some people will be at a disadvantage:

Some previously on Medicaid might have to pay more, although there is assistance available for some low-income folks.

Seniors are "locked in" once they have chosen a plan until the next signup period. But there's nothing that keeps the plans from changing which drugs they cover at any time.

The coverage stops at $2,250 in a single year. It picks up again for for those with more than $5,100 a year in prescription expenses - but that leaves a "coverage gap" for people who fall in between.

In sum, Medicare Part D is an odd-looking beast designed by the biggest committee possible, the U.S. Congress.

Meanwhile, the hit to taxpayers is enormous. This program was sold to Congress on the idea that it would cost $400-billion over 10 years, but already the estimates of the true cost is well over $1-trillion. The worst thing is that the government is specifically forbidden from trying to negotiate lower prices with drug companies. Awful!

Yet it is a done deal. The May 15 deadline looms. It was good, at least, to see so many folks taking the initiative and signing up. It also was good to see those who found, despite the confusion and complications, that they may be better off.

Local signups like the one in Gulfport are being staged by a nonprofit group called My Medicare Matters, sponsored by the National Council on Aging, the Access to Benefits Coalition and the pharmaceutical company AstraZeneca. For information visit the Web site at www.mymedicarematters.org

The official U.S. government Web site for Medicare is www.medicare.gov The toll-free number for information is 1-800-MEDICARE, or 1-800-633-4227.

Good luck.

[Last modified April 22, 2006, 20:43:02]