From USA Today:

Staffing shortages are hampering the start of Medicare’s prescription-drug program in many states, forcing seniors and those with disabilities to wait weeks for counseling.

The delays could slow enrollment of up to 30 million Medicare beneficiaries by May 15, the deadline to sign up before penalties raise the cost of entering the program. State and local officials have appealed to the federal government for money, staff and laptops.

“It’s a numbers problem,” says Matt Denn, Delaware’s insurance commissioner. “We can’t win unless something changes.”

Frustrations boiled over last week at a meeting in Newark, Del., when Denn told U.S. Health and Human Services Secretary Michael Leavitt that “there are some real significant problems.” The state has four staff members to advise 120,000 seniors, Denn says. Each day they handle about 40 calls, but about 60 go unanswered.

Federal officials say they anticipated the rising demand for assistance and did several things to handle it. They increased funding for state insurance counseling programs from $12 million two years ago to nearly $32 million this year — 60% more than the Medicare program’s advertising budget. They solicited help from outside groups, such as churches and colleges. And they attracted about 1,000 more volunteers.

State programs “are one resource. There are plenty of others,” says Kathleen Harrington of the Centers for Medicare and Medicaid Services. She acknowledges, however, that state counselors are the best trained to advise seniors.

In many states, those counselors are falling behind:

• Oregon, with four counselors and about 200 volunteers to handle 540,000 Medicare beneficiaries, is two weeks behind answering calls. “We get a lot of people who hang up,” says Claudia Grimm, who manages the state health insurance program. Officials have asked drug companies for laptops to help enroll people.

• In New York, the Medicare Rights Center has a backlog of 2,000 calls. Robert Hayes, its president, predicts the situation nationwide will get worse around Christmas. The prescription-drug coverage begins Jan. 1, and calls are likely to increase. “We cannot meet anywhere near the demand,” Hayes says.

• Missouri, with eight workers and 200 volunteers, also is two weeks behind. Officials are scheduling events into next March. “We need more volunteers,” says program director Carol Beahan.

• In Phoenix, home to many of Arizona’s 800,000 eligible seniors, officials work nights and weekends. “We are getting swamped,” says Ann Marie Grande, program manager in Maricopa County.

• Michigan has four staff members to serve 1.5 million Medicare recipients. In October, the office fielded 13,000 calls, compared with 43,000 all last year. “They need to be patient with us,” executive director Mary Johnson says.

According to a Better Business Burea Report, crooks are calling seniors pretending to be Medicare Part D Prescription Drug Plan providers or government officials, and offering to enroll them in the program over the phone. The criminals then use the personal and financial information they coax from the seniors for the purposes of identity theft.

The following advice was offered to keep Seniors safe from these scam artists.

• Carefully review the “Medicare & You” 2006 handbook that has been provided to every senior citizen. The booklet explains in detail what prescription drug coverage means to you and which plans are available in your area.
• Legitimate providers are permitted to contact consumers, but they must observe federal and state do-not-call laws and registries. Also, they should be willing to send you information about the plan in the mail, and to wait to obtain any necessary personal and financial information until after you decide to enroll.
• If someone calls you out of the blue to offer a Medicare prescription drug plan and asks for personal and financial information, obtain their name, the name of their company or agency, and their phone number. Ask them to send you information about their plan in the mail. Do not provide your bank account number, your Social Security number or any other personal information over the telephone.
• Verify the legitimacy of any provider that contacts you by calling the Medicare toll-free phone number, (800) MEDICARE (800-633-4227), which is open 24 hours a day.

From a November 28 Press Release by PacifiCare Health Systems:

The commercials feature a group of wary seniors whose doubts are
entertainingly expressed up close in unconvinced winces, dubious chin-strokes
and suspicious squints. Eventually, the diverse group of doubters is won
over, convinced by the clear messages about quality benefits, affordable plans
and cost savings.

I’m not sure how well skeptical seniors are going to respond to commercials that simply say “don’t be skepitcal about medicare part d, sign up now!”, but I’m sure it will pick up some customers. PacifiCare will continue running their first ad, which stars Fred and Ethel from I Love Lucy.

From the Chicago Tribune:

Gov. Rod Blagojevich joined top state Democrats Sunday in an effort to buy senior citizens extra time to wade through a Medicare prescription-drug program many have called confusing.

In a letter to Mark McClellan, head of the federal Centers for Medicare and Medicaid Services, Blagojevich said he supports a bill sponsored by U.S. Rep. Jan Schakowsky (D-Ill.), U.S. Sen. Dick Durbin (D-Ill.) and others that would extend the deadline for seniors to choose from among dozens of plans.

Enrollment for the voluntary program began Nov. 15 and is slated to end May 15.

The bill would move the deadline to the end of 2006 and allow seniors to change their plan one time if they believe they have made a mistake.

Seniors are able to sign up for a plan at any time, but missing the deadline results in a penalty of 1 percent of the plan’s premium for every month they wait.

Blagojevich cited research that shows nearly three of four seniors are “confused and overloaded by the vast array of plans they’re asked to choose from.”

“Most senior citizens are confused by the complexity of the program,” the letter says. “They’re concerned about making the wrong decision. And they need more time to decide which plan is best for them.”

Illinois seniors have said that choosing from the approximately 40 plans offered in the state–which include variations in price structure, covered medications and participating pharmacies–has been difficult.

Federal officials have said seniors have enough time to sort through their options, aided by thousands of community groups across the country trained to provide one-on-one help.

I personally think that if eligible citizens can’t decide on a plan in 7 months, adding 7 more won’t help anything.

I found this editorial in the Houston Chronicle:

The good news about the new Medicare drug benefit
Seniors are already seeing savings in prescription prices
By U.S. REP. TOM DELAY

TWO years ago, when Congress took up a bill to strengthen and improve Medicare and provide American seniors with a prescription drug benefit, I didn’t need any convincing. It was a good bill, a conservative bill, and the first time in history Congress introduced competitive, market-based reforms to a government bureaucracy created 40 years ago. It was the right thing to do, for seniors and for taxpayers.
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After almost a decade of promises — mostly from Democrats — and legislative negotiation — mostly by Republicans — we delivered. The final bill created the drug benefit, health savings accounts and other market-based reforms, all without raising taxes. It was a tremendous, bipartisan achievement.

In the two years since Congress passed and President Bush signed the largest entitlement reform bill in history, a lot has happened. The national agenda in that time has been understandably dominated by other issues, but this week’s opening of the registration period provides us an opportunity to assess the new program and begin to think about how it will impact our lives. Elected officials now have a responsibility to seize this opportunity to clarify, inform and educate.

First, the good news.

Though you may not have heard much about it, many of the most common prescription medicines used by American seniors have already seen their prices drop since Congress created the drug benefit two years ago. Indeed, the projected cost of the benefit to taxpayers has dropped $100 billion (14 percent) already because of the competitive reforms we introduced. Our decision to provide the drug benefit through private companies rather than a government bureaucracy has paid off in the diversity and affordability of the plans now available to American seniors. And finally, Congress’ goal to provide the most immediate and profound assistance to lower-income seniors is being met by the low-cost — in some cases free — plans being offered to them.

Tens of millions of seniors — including 500,000 in the Houston area — are now eligible to get the kind of low-cost, effective prescriptions that will not only save lives, but, in time, save money as well. Which is the better investment, helping seniors get medicine to stay out of the hospital, or paying for long, expensive hospital visits?

The obvious answer to that question is the reason Republicans — not Democrats, but conservative Republicans — passed this bill into law. It was a good bill, and the early results are bearing that out.

Of course, there is also some degree of confusion among seniors, their families and their health care providers.

“Which plan is best?” many ask.

“How do I sign up?”

“How do I compare plans if I don’t have Internet access?”

“Are the plans better than the insurance I may already have?”

These are natural questions, given the comprehensiveness of the change and the diversity of options seniors now have. That is why it is so important for public officials — those who supported the bill and those who didn’t — to reach out to seniors in their communities to provide assistance and information.

This ongoing dialogue is important not only for the program’s beneficiaries — to ensure they get the best coverage possible — but also for policy-makers, who are going to be continually called upon to modernize and strengthen Medicare to meet seniors’ changing needs.

For my own district, I organized several workshops and town hall meetings that gave me the opportunity to speak directly with seniors and to hear their concerns. Over the next few months, I will be holding even more of these workshops to help answer these questions and provide as much information as possible to sign seniors who are signing up for the program.

It seems to me every congressman and woman in the country ought to be holding them, too. There is already a major citywide event planned to help seniors enroll in the program on Jan. 28, and similar events will be planned across the state and nation in coming months.

This program can save lives, and it’s our job as public officials — and the media’s, as stewards of the public trust — to help it succeed for the sake of current and future seniors relying on us for their health care. We all know people struggling to get by because of their medical bills; this program is an opportunity for us to give them a chance.

Today, November 15, is the first day of Medicare Part D’s open enrollment period. The program won’t begin until January 1, however. If this is your first time looking into Medicare Part D, I recommend checking out the Medicare Part D Overview.

It’s a good thing that seniors have plenty of time to enroll in this program, because confusion still abounds. According to an article on Newday.com:

In New York, senior citizens have 46 plans to sort through. Premiums range from $4.10 to $85.02 a month. Annual deductibles run up to $250. Also, most plans contain the so-called “doughnut hole,” which requires you to pick up the full tab once your drug expenses reach $2,250 until they hit $5,100, when “catastrophic” coverage kicks in, covering 95 percent of the price.

Even more important than these costs are what drugs the plan covers and how much you’ll pay.

As part of the Detroit Free Press’s series on Medicare Part D, the question of whether or not Veterans need Medicare Drug Coverage has been answered.

ANSWER: Your VA coverage is considered as good as Medicare’s coverage, therefore you may keep the VA coverage and waive the Medicare Prescription Drug coverage.

If you change your mind later, you can enroll without paying a late enrollment penalty. Medicare has a fact sheet on Department of Veterans Affairs benefits and how they work with the Medicare prescription drug coverage. You can obtain a copy of this fact sheet by calling 800-633-4227, by calling the Department of Veterans Affairs toll-free at: 800-827-1000 877-486-8387 or by calling an MMAP counselor at: 800-803-7174.

The answer to today’s question comes from experts on the new law at the Centers for Medicare and Medicaid Services (CMS), the federal agency that administers Medicare and Medicaid; the Medicare Rx Education Network in Washington, D.C., and the Michigan Medicare/Medicaid Assistance Program (MMAP).

MMAP volunteer counselors are available at 800-803-7174 and can provide information about upcoming events where experts will answer questions.

The long awaited Medicare Prescription Drug Plan finder has finally been launched. It can be found here.

With a limited amount of information (Medciare Claim Number, Last Name, Date ofBirth, etc.) the program is supposed to be able to determine the available plans in your area, then further narrow them down by the plans that cover the drugs you take.

I am personally not a Medicare user, so if any of you would like to test the software and then post a comment about it here, it would be much appreciated.

According to The Detroit News:

With the starting date for the federal government’s new Medicare prescription drug plan approaching, the program has begun randomly enrolling beneficiaries who are also on Medicaid into approved drug plans.

Medicare last week began sending beneficiaries letters telling them which plans they have been assigned to effective Jan. 1. The action affects about 5.5 million people who are eligible for both Medicare and for Medicaid, the federal health care program for low-income individuals.

Each “dual eligible” beneficiary has been put in a plan with no premium, no deductible and low co-payments.

Medicare beneficiaries who are not eligible for Medicaid have to sign up for the program and choose a plan.

Enrollment begins Nov. 15.

About 5.5 million “dual eligibles” have randomly been assigned a plan with no premium, no deductible and low co-payments.

The federal government opted to automatically enroll dual eligibles — who tend to be among the poorest and sickest and often include nursing home residents — so they do not lose coverage during the transition.

“We needed to get the letters out now, so people know they will either need to take action come Nov. 15 or not take any action and be automatically enrolled in a plan,” said Peter Ashkenaz, spokesman for the Centers for Medicare and Medicaid Services in Washington, D.C.

Dual-eligible recipients can change plans every month, as many times as they like.

Medicare recipients who are not on Medicaid can change only once within the enrollment period.

Some health advocates are concerned dual eligibles will be assigned plans that don’t cover their drugs or don’t contract with their local pharmacies.

“You have coverage, but you might not have the right coverage,” said David Lipschutz, staff attorney for California Health Advocates, a nonprofit group in Los Angeles.

So long as the government performs due dilligence in selecting plans that are strong in the Medicaid user’s geographical area, this shouldn’t prove too problematic. We’ll see how it shakes out, though.

From MLive.com:

Medicare’s new prescription drug benefit - which starts Jan. 1 - is giving many companies a headache as they scramble to decipher the guidelines.

In fact, some employers - either because they’re unprepared or unaware - will likely miss the Nov. 15 deadline to send eligible employees, retirees and dependants a notice that essentially defines the company’s drug plan as better or worse than the Medicare Part D plan.

And that could cost employees higher premiums if and when they do subscribe to the Medicare plan. “My guess is that there is going to be many, many employers who don’t send out the notice to their employees,” said Mark Nixon, president of Royal Oak-based Allied Group Insurance Services Inc. of Michigan.

Nixon and his staff have been working with many of Allied Group’s 450 business clients to interpret and meet the requirements of Part D, which was signed into law in 2003. The plan - expected to cost the government $724 billion over the next decade - offers prescription drug benefits to the 42 million people on Medicare, most of whom are 65 and older.

The law requires employers with any Medicare-eligible plan participants to send a notice every year to these participants outlining whether the company’s drug plan is “creditable” or “non-creditable” - in other words, whether it is of lesser or greater value than Part D.

The notice must be sent to eligible active employees and retirees as well as their spouses and dependent children.

The value determination is based on a complicated actuarial formula that employers can’t make without guidance from their prescription drug provider - and many providers dragged their feet in providing the information, said Sue Mathiesen, director of technical services for Troy-based McGraw Wentworth, a group benefit brokerage and consulting firm.

It is really going to be interesting to see how everything plays out with all this confusion. We’re less than two weeks away from the beginning of Medicare Part D Enrollment. Fortunately everyone has a few months to enroll before the rate increases begin.