Drug cutoff brings plight

Seniors who fail to sign up for Medicare benefit by May 15 face big risks, including penalties to join and higher premiums

Name : MATT PACENZA, Staff writer

First published: Sunday, May 7, 2006
Ever since it became law in 2003, the new Medicare drug benefit has been the stuff of big claims. Its backers called it an elixir for struggling seniors, while opponents decried it as a massively flawed plan.

Today, with only eight days left for seniors to sign up for coverage, rhetoric is again heating up.

“For people who have nothing, this bus is leaving the station, and it’s leaving thousands of seniors behind,” said Sen. Charles Schumer, warning at a news conference last week that New Yorkers who aren’t signing up for Part D face “serious consequences.”

If seniors miss the May 15 deadline and try to join the plan later, they’ll face substantial penalties, including premiums that are at least 6 percent higher.

But polling data shows that the situation for seniors may not be so dismal. About 350,000 New Yorkers — including roughly 40,000 in the Capital Region have Medicare coverage but have not signed up for Part D. Surveys suggest that about half of those seniors know plenty about the new Medicare drug benefit, but decided to go without it.

“People do have very rational reasons for deciding they don’t want it,” said Mark David Richards of KRC Research, which surveyed almost 900 seniors on Medicare.

“Some people have really evaluated their choices and have made a conscious decision to sit on the sidelines for now,” added Juliette Cubanski, a policy analyst with the Kaiser Family Foundation, a leading health care research organization.


About 20 million Americans now get their prescription drug coverage from Medicare Part D. Officials had hoped that up to another 10 million seniors and people with disabilities would sign up.

The looming deadline has prompted consternation, according to the advocates who handle Part D questions. Calls to hot lines have picked up substantially over recent weeks.

“Our phones won’t stop ringing,” said Jennifer McCarron, the help line coordinator for StateWide Senior Action, an Albany-based group that advocates for aging New Yorkers.

Both anecdotal evidence and polls show there are plenty of seniors who might miss the deadline not because they’ve made an educated choice, but because they don’t know about it or are overwhelmed by Part D’s complexity. One factor is the sheer number of choices: 47 insurers in New Yorkers alone offer coverage.

“The fact that there are so many plans to choose from has people baffled,” said Leo Torrey, an outreach coordinator with StateWide Senior Action.

Seniors have also been influenced by the tales of woe that made news when the drug benefit began on Jan. 1. Some didn’t get drugs, others erroneously paid high co-pays, and countless seniors spent hours battling bureaucracy.

Like Ralph William Shields of Albany, who fought to overcome “oblivion by automaton” earlier this year when he couldn’t get state and federal bureaucracies to correctly identify him as someone who gets both Medicare and Medicaid, the health care program for low-income Americans.

Shields, 53, is a Medicare beneficiary because he was disabled by a traumatic brain injury he received in a car crash in 1987.

Source : http://www.timesunion.com/AspStories/story.asp?storyID=479245&category=REGION&newsdate=5/7/2006


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