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Jewish World Review
Nov. 17, 2005
/ 15 Mar-Cheshvan, 5766
If you didn't need drugs before enrolling ...
By
Lenore Skenazy
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http://www.JewishWorldReview.com |
Next time I visit mom in Chicago she has me penciled in for a very special evening (and morning and evening and 3 a.m. break to bang our heads on the living room floor): We're going to figure out her Medicare Part D.
You know — the new prescription insurance program that was created to help seniors. Or, as my mom puts it, "Kill them."
She's a little testy because she has been trying to figure out how to choose between the 40 or so plans she is eligible for. The fact that she might accidentally choose one that doesn't include her local pharmacy or her current prescriptions is driving her nuts. So nuts that, like four out of five seniors polled by the Kaiser Family Foundation, she considered not enrolling at all.
Things have to be pretty bad when the government is giving senior citizens a new $800billion benefit and the citizens are ready to catapult flaming gurneys into the Capitol.
"Really, now, how confusing can it be?" I tsked, going to Medicare.gov on my computer and finding a completely user—friendly explanation of the basics:
A "premium" is the amount you will have to pay each month. Very clear.
A "deductible" is the amount you must pay before the plan kicks in. Gotcha.
"Copayment/Coinsurance is the amount you pay for your prescriptions after you have paid the deductible. In some plans, you pay the same copayment (a set amount) or coinsurance (a percentage of the cost) for any prescription. In other plans, there might be different levels or 'tiers' with different costs. (For example, you might have to pay less for generic drugs than brand names. Or, some brand names might have a lower copayment than other brand names.) Also," — yes, this is still the simple explanation of copayment — "in many plans your share of the cost can increase when your prescription drug costs reach a certain limit."
Okey—dokey. So maybe Mom had a point.
"It's asking grandpa to program the VCR," is how Michael Cannon, author of "Healthy Competition," sees the program. In 1966 when Medicare itself rolled out, he notes, one plan covered everyone.
Today there are 50 insurers with a kaleidoscope of plans. Some pause in their aid after the first $2,250, some don't. Some cover brand names, some don't. Some are $4 a month, some are $85, but frankly, any one of them is better than nothing. And that's what my mother and 85% of senior citizens had before this plan: zero help paying for their prescriptions. If only the plan were a tad simpler, everyone would be ecstatic.
So I called the Medicare press office and got the guy in charge of making things sound easy. Guess what? He gave me a great tip: Skip all the other links and click on, "Medicare Prescription Drug Plan Finder." Fill out the little form with your Medicare number, prescriptions and zip code and — voilà! Instead of 40 local plans, it should narrow you down to a handful.
Of course, you still have to choose from that handful. And if you don't have a computer, you have to invite someone over for an evening (and morning and evening) to help sort out the paperwork. Or you can call (800) MEDICARE. By then, you may need Valium.
Make sure your plan covers it.
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JWR contributor Lenore Skenazy is a columnist for The New York Daily News. Comment by clicking here.
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© 2005, NY Daily News
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