Part D a blessing for some, a burden for others

Those hurting the most formerly got prescriptions through Medicaid or the pharmaceutical industry's lower-cost programs.

Published May 7, 2006

Call it a draw.

Some Citrus residents who are enrolled in Medicare Part D report significant savings. Others haven't been so lucky.

"It helps everyone who's been buying their own drugs," said Harvey Roberts, a volunteer for Serving Health Insurance Needs of Elders, or SHINE, a group that provides free health insurance information and counseling. "It doesn't help people who have been getting help from drug companies, Medicaid."

But whatever their potential savings, those without prescription drug coverage need to make decisions quickly. The deadline for this year's enrollment cycle is May 15.

As of March 18, nearly 50 percent of those eligible in the county had signed up for Part D, according to U.S. Rep. Ginny Brown-Waite's office. That does not include residents who receive drug coverage through other programs, such as veterans assistance.

Constituents have told Brown-Waite that they have saved "a ton and a half," she said during a recent visit to a Hernando County pharmacy.

Some have.

With diabetes, heart disease and thyroid problems, Mary Linder's out-of-pocket expenses for medications would exceed her monthly income. When she lost her work health insurance at 65, she stopped taking all prescriptions.

"I told my doctor, "Plain and simple, I cannot afford them,"' said Linder, 71, of Inverness. "So he said either I had to figure out a way to afford them or go home and die."

Linder scrimped, even forsaking meals, to pay for only the most vital medications. Later, with a prescription discount card, she was able to bring the cost down.

An error on Linder's initial application recorded her income as too high for Part D's extra help provision, but that was fixed and now she's pleased with her coverage.

For a cocktail of medications that would cost more than $600 a month, Linder is shelling out only a few manageable co-pays.

"I think this is going to benefit a lot of people," she said.

But for some, the co-pays make a huge difference.

Claudette Taylor, 54, of Crystal River was automatically enrolled in a Part D plan after getting her medicine through Medicaid. Now she has to contribute co-pays to her nine medications, which she never had to do before.

It comes to about $100 a month, too expensive for her limited disability budget.

"They're hurting us," she said. "It's just for rich people, a ripoff."

Other than Medicaid recipients, the other group most negatively affected by Part D includes people who were under reduced-price drug programs operated by the pharmaceutical industry, Roberts said. Now some aren't covered by those programs but also have incomes higher than the threshold of Part D's extra help provision.

With such mixed experiences, many can't decide whether to enroll, even with the deadline approaching, Roberts said.

"Lots of people have enrolled, gotten their cards, gone to the drugstore and it works," he said. "But lots still have questions and need help.

The 44 plans offered in Florida through 19 companies can be daunting to navigate, he said.

"So many seniors are so confused. They don't know where to go, who to turn to, who to trust," Linder said. "But older people need medications; it's inevitable."


Medicare information: 1-800-633-4227

Eldercare hotline: 1-800-963-5337

www.medicare.gov www.mymedicarematters.org www.socialsecurity.gov/prescriptionhelp www.sptimes.com/2005/webspecials05/medicare/archive.shtml