.
"HELP IN
UNDERSTANDING
THE NEW
MEDICARE
DRUG
PROGRAM"
.Feb.
4, 2006
Featuring:
Links To Shed Light On All Aspects Of The Program
May 15/06 Deadline To Sign Up.
Gerry M. Kaye
WASHINGTON -A Bush administration official acknowledged Thursday that the Medicare prescription program was too complicated for many of its intended beneficiaries to understand and said that simplifying it was a top priority. "Simplification is absolutely the next step in this process, now that we've got the benefit in place," Medicare Administrator Mark B. McClellan said during a Senate hearing on problems the program has had since its Jan.1/06 introduction.
At the same time, McClellan opened the door to a possible extension of the May 15 deadline for signing up, a step the administration has opposed but critics have said is needed to give seniors time to figure out the program's options. Under current rules, if Medicare recipients fail to enroll before May 15, they will have to pay higher monthly premiums permanently.
Hundreds of thousands of seniors enrolled in the benefit program have run into delays or outright refusals in getting medications.
Many pharmacists have yet to be paid by the private drug plans that contract with Medicare to deliver the government-subsidized benefit. At least 20 states stepped in with financial guarantees to make sure beneficiaries could get the medicines they needed; the administration agreed to reimburse the states.
The White House has promoted the drug benefit as a historic accomplishment and the most significant improvement to Medicare since its establishment in 1965. Spokesman Trent Duffy said Thursday that President Bush remained committed to the program.
Separately, the Medicare agency released estimates indicating that the drug benefit would cost less than expected: $678 billion over the next 10 years instead of the $737 billion projected last year. The average monthly premium for seniors this year is expected to be about $25, or 22% less than the $32 estimated in August. McClellan said the main reason for the lower estimates was "robust competition" among the private insurers offering coverage. Other data released by the government suggested another factor might be at work: The previously rapid rate of increase in drug costs has slowed dramatically in the last two years because of a shift to generic medicines and other reasons.
Sen. Bill Nelson, D-Fla., offered an amendment Thursday night to tax legislation that would have given Medicare beneficiaries until Dec. 31 to enroll without penalty. The current deadline is May 15.
Senate Rejects Medicare Deadline Extension
While Senate Democrats could not muster enough votes to extend the enrollment deadline for the new Medicare drug benefit, many lawmakers sound like they're going to continue to try to make changes in the program. The amendment also would have allowed people to switch their prescription drug coverage to another plan if they were unhappy with current coverage.
In a partisan-led opposition that preferred an earlier democrat proposal to the government's new benefit, the amendment received a majority of votes, 52-45, but needed 60 to pass under Senate rules for measures concerning budgets and taxes. Nelson said his amendment was a chance for lawmakers to act on complaints they've heard from their constituents since the program began Jan. 1.
Republicans also said during an earlier congressional hearing that they have heard from people who have had difficulty filling prescriptions or were charged more than they should have been. They told Mark McClellan, head of the Centers for Medicare and Medicaid Services, that the program should be fixed, not scrapped.
"It is nearly impossible to avoid startup challenges, but we now we must identify those individuals who are vulnerable and make certain that their needs are met," Sen. Elizabeth Dole, R-N.C., said.
McClellan said the government makes "no excuses for the problems. They are important, they are ours to solve, and we are finding and fixing them."
The Bush administration had asked private insurers to supply older people with an additional 60-day supply of medicine in emergency cases.
That will give beneficiaries more time to find alternative treatments when their plan will not cover a prescription or more time to file an appeal. Pharmacists had warned that the previous 30-day limit could pose significant problems for poor older people and the disabled.
The program is working for most, McClellan said, and competition among the private plans was driving down costs.
Premiums will average about $25 a month, as opposed to the $37 projected when the program was approved. McClellan's agency now estimates the program will cost about $678 billion over 10 years rather than about $730 billion.
The most critical assessments of the program are coming from Democrats. When McClellan said the agency was trying to make the program "even easier" to understand, Sen. Ron Wyden, D-Ore., quickly interrupted: "Even easier? It's bedlam out there."
About 42 million older people and the disabled are eligible to participate in the drug benefit. They do so by enrolling in a private insurance plan. The benefit should lower drug costs for most participants because the government is subsidizing their drug costs.
Dozens of states have stepped in, temporarily paying for medicine that beneficiaries have been unable to get through Medicare. McClellan said the government would work to make sure that private plans reimburse the states.
Under the drug benefit, seniors must pick from dozens of plans, each with its own list of covered medications, cost-sharing policies and internal rules.
REFERENCES:
NEWS: February 3,
2006 "Medicare Chief Acknowledges Benefit Snags" By Ricardo Alonso-Zaldivar,
L. A.Times Staff Writer.
NEWS: February 3, 2006 "Senate Rejects Medicare Deadline Extension" By KEVIN FREKING, AP
Helpful Links @ Medicare.gov:
Information
To Understand the New Medicare Drug Program:
http://www.medicare.gov/pdphome.asp"
THINGS-TO-CONSIDER:
Convenience
Peace of mind now and in the future
COST:
http://www.medicare.gov/pdp-things-to-consider.asp#Cost
COVERAGE:
http://www.medicare.gov/pdp-things-to-consider.asp#Coverage
Etc.
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