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Medicare Part D help tool is incomplete

October 24, 2005
By: Leslie Yingling
State Capital Bureau

JEFFERSON CITY - Medicare officials have designed a handful of online tools to allow people to search for and compare the first-ever precription drug plans under the federal insurance program. Despite a promised mid-October unveiling, many are not yet available at the Medicare Web site,

In less than a month, more than 800,000 elderly and disabled Missourians will have the option for first-ever prescription drug coverage under the federal health insurance program. Right now, looking at specific plans online means wading through a slew of information and waiting for more.

In Missouri, 15 private insurance companies will offer one or more prescription drug plans under Medicare Part D. Premiums, deductibles and copayments will vary by insurer, while each plan will cover specific drugs and work through certain pharmacists.

A search device that will allow users to search for plans in their area based on what drugs they need and what pharmacy is most convenient is incomplete. When it becomes functional, Medicare officials say the Prescription Drug Plan Finder will also calculate how much each plan would cost.

At CLAIM, a Columbia-based organization that offers free Medicare help, counselors hoped the tool would be uploaded -- and fully operational -- by Oct. 17.

"There is enough information to get started and narrow the selection, but not enough for people to make decisions about specific plans," said Carol Beahan, CLAIM program manager.

Right now, the Landscape of Local Plans tool lets users look at plans offered in their state and county, and a formulary finder shows which providers will cover specific drugs. Another tool can estimate users' potential savings under Medicare Part D, based on what they pay per month for prescription drugs, and what state they live in.

"People are eager to have all the information," Beahan said. "They'd enroll today if they could."

CLAIM counselors are fielding more than 100 phone calls every day, she said.

"It's a good problem," said Diana Brady, a CLAIM trainer.

Phones are ringing off the hook in the Southwest Missouri Office on Aging, with 150 to 250 calls daily, said resource development director Andrea Porter.

"We honestly are flooded with phone calls and walk-ins," she said.

"People are anxious and they are getting frustrated."

Parker said it was "too bad" the online tools are not all available. "We expected them to be fully functional by last Monday," she said. "We check for updates every day."

Julie Brookhart, a spokesperson for the Kansas City regional office of the federal agency that runs Medicare, attributed the Web site delays to some deadline extensions.

Employers and unions that offer health insurance now have until Oct. 31 to decide whether they will maintain prescription drug coverage. If so, they can apply for federal subsidies that will allow them to be more competitive with plans that carry the Medicare drug benefit.

Brookhart also said there's no need to rush, emphasizing Medicare's sixth-month enrollment period.

"They have from Nov. 15 to May 15 to enroll," she said.

But the sooner beneficiaries enroll, the sooner they get coverage. Those who enroll by Dec. 31 will receive coverage beginning Jan. 1, 2006. After December, Medicare beneficiaries who enroll in a Part D drug plan will get coverage at the start of the following month. Those who do not meet the May enrollment deadline will have to pay higher monthly premiums, unless they currently have prescription drug coverage that measures up to Part D standards.

Brookhart said Medicare administrators have guaranteed that all of the online tools will be fully functioning when Medicare enrollment opens on Nov. 15.

"We can only hope that it is in a timely manner, and soon," Porter said.

Beahan said although there isn't sufficient information available for people to choose a Medicare drug plan, there is plenty of preliminary work that people can do on their own.

Beahan advises Medicare beneficiaries who already have prescription drug coverage through a private company, employer or union to examine how their coverage compares to plans under the new Medicare drug benefit.

"If they have a drug plan that's equal to or better than a Medicare plan, they may not need to enroll, she said.

Employers and unions are required to send letters to customers explaining whether they cover as much or more than what Medicare requires. Most people should have received those letters, she said, but some may still be in the mail.

Medicare beneficiaries should also list the drugs they need, identify their preferred pharmacy, and apply for financial assistance, Beahan said.

The Southwest Missouri Office on Aging and Sen. Roy Blunt are hosting a Medicare Part D fair in Springfield. Porter said the participating insurance providers will be there, and formulary lists will be available, to fill in some of the information that is not yet available online.

CLAIM has scheduled informational sessions throughout the state into December, including one in Columbia Dec. 8 at 200 N. Keene St.

Beahan also encourages people to call CLAIM for more information, 800-390-3330.

"We know our lines are busy, but we return all phone calls," she said.