| SIGN-UP STARTS NOV. 15
By Bob Weaver
A survey by MetroNews and other state newspapers says about 95% of the public does not understand the new Medicare prescription plan.
Seniors must start now signing up for Medicare's new plan to help them with their prescription drug costs.
The new plan commences paying benefits on January 1, 2006.
Medicare recipients have received a 100-page book "Medicare and You," to help them understand the new program.
The book, in itself, is a little overwhelming.
Then there are dozens of private plans, some of which could be beneficial and others could provide just a little help with drug costs.
All the private providers will say they are the best.
Certainly, Medicare holders need to read the book, or have someone close to them read the book.
Calhoun residents who have problems understanding the plan, should contact Opal Harris at the Grantsville senior center. She is Calhoun's Senior Health Insurance Program (SHIP) counselor.
Harris says "We understand this information may be very confusing," and that is why there is a SHIP counselor in every county.
Thousands of WV citizens did not enroll in Medicare's temporary prescription drug plan, which was described as a confusing process, particularly in deciding on a provider.
Harris is available by phone at 354-7822 or people can stop at the center.
It is the responsibility of seniors on Medicare to select a plan that will benefit them.
The new prescription drug plan will help seniors save money on their prescriptions.
It is important to compile a list of prescription drugs taken regularly and total their annual cost.
If you spend $600-$700 a year or more on drugs, the new plan will probably be a good deal for you economically.
Monthly out-of-pocket costs vary from plan to plan.
Monthly premiums run from as low as $6-$7 to as high as $40.
You see where a problem could commence.
One official said the average cost for the new plan from the dozens of insurance companies is $37 a month, or a bit less than $450 a year.
The first $250 in drug outlays will be your "deductible," on which you'll pay the full cost of your prescriptions.
So if the "average" out-of-pocket costs is $37 a month, plus the $250 deductible, this means most holders will be paying about $700 annually for their medications using the new program.
Now, it gets a little more complicated.
The first level of coverage will cover 75 percent of all drug purchases from $250 to $2,250.
At the second level you will pay the full cost of all your drug purchases on your next $2,280 in drug costs. Then "you pay 5 percent (or a small co-payment) for the rest of the calendar year after you have spent $3,600 out of pocket. Your plan pays the rest," according to the official booklet.
The booklet repeatedly suggests that you go ahead and enroll, even if you don't have a pressing need for drug coverage.
If you wait until you need it to register, you will have to pay a penalty that will result in higher premiums later.
The penalty is an increase of 1 percent a month for every month of eligibility you don't take advantage of the sign-up opportunity.
The only exceptions are for those still working and already covered by an employer or union plan, or retirees still covered by corporate or union plans that include prescription drug coverage.
If you are still covered by a private plan, you need to ask the plan if you are exempt from premium penalties later.
The booklet says a low-income beneficiary can pursue "help options" if you make your need known and your income is low enough.
You should inquire about those "help options."
You may want to visit your neighborhood druggist where you do most, of your drug-buying.
They will likely be of help, but they too are on the spot, trying to wade through the dozens of program.
If you are the child of an elderly person who seems to have problems with such complex information, we suggest you help them.
You could have a problem understanding the system, too.
The important thing is not to get overwhelmed and use that as an excuse to put off getting started.
If you want to participate, the sooner you get started, the sooner your benefits will start flowing.
ENROLLMENT SCHEDULE:
November 15 - Enrollment begins (info on www.medicare.gov)
December 31 - Medicaid drug coverage ends for Medicare beneficiaries. Previous Medicare drug cards end.
January 1, 2006 - New Medicare drug coverage begins
April, 2006 - Reminders will be mailed to those not enrolled
May 15, 2006 - LAST DAY to enroll without penalty
The following 19 organizations will offer stand-alone prescription drug plans to Medicare recipients in West Virginia, according to the Centers for Medicare & Medicaid Services:
_Aetna Life Insurance Co.
_American Progressive Life and Health Insurance Co. NY/Marquette National Life Insurance Co./Pennsylvania Life Insurance Co.
_Avalon Health Ltd.
_Connecticut General Life Insurance Co.
_Coventry Health and Life Insurance Co./First Health Life & Health Insurance Co.
_Highmark Senior Resources Inc.
_Humana Insurance Co.
_Medco Containment Life Insurance Co.
_MemberHealth Inc.
_Pacificare Life and Health Insurance Co.
_QCC Insurance Co. D/B/A AmeriHealth Insurance Co.
_RxAmerica LLC
_Silverscript Insurance Co.
_Sterling Life Insurance Co.
_Unicare
_United American Insurance Co.
_United Health Care Insurance Co.
_UPMC Health Plan
_WellCare Health Plans
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