Prescription plan complicated, but it can be sorted out.Byline: GUEST VIEWPOINT By Jerry Harden For The Register-Guard Many Oregon seniors and disabled people are confused about the complexities wound into the new Medicare Part D prescription drug prescription drug Prescription medication Pharmacology An FDA-approved drug which must, by federal law or regulation, be dispensed only pursuant to a prescription–eg, finished dose form and active ingredients subject to the provisos of the Federal Food, Drug, program. Unfortunately, many authorities trying to present factual information are misstating some plan components, adding to the problem. First, it is important to reject the concept of the "typical beneficiary." Some people will benefit greatly. Others will receive little if any benefit. And still others will be hurt by the new plan. Prospective enrollees need to consider each component of every plan being considered. Eugene Mayor Jim Torrey's reference in a Nov. 15 guest viewpoint to the "typical beneficiary" applies if monthly drug costs are about $200. People paying $30 per month will actually have higher out-of-pocket costs out-of-pocket costs Managed care Health care costs that a covered person must pay out of pocket–eg, coinsurance, deductibles, etc. See Copayment. than if they had no program. People paying $500 per month will experience a savings of about 33 percent. The new drug plan will pay 95 percent of drug costs in excess of $5,100. It is people with catastrophic needs who will benefit the most. Exercising the option Exercising the option The act of buying or selling the underlying asset via the option contract. of not enrolling may or may not be a good strategy, due to the penalty element of the program. A plan with low monthly premiums may prove more expensive than a plan with higher premiums, but with less expensive copays. I am concerned that Torrey implies that the new program is a fine example of free enterprise. He states, "As a result of strong competition, Oregon's Medicare recipients can select from a wide array of options. ..." A more honest statement might be: As a result of strong competition and influence peddling influence peddling n. The practice of using one's influence with persons in authority to obtain favors or preferential treatment for another, usually in return for payment. influence peddler n. in the halls of Congress, Oregon's Medicare recipients are forced to negotiate a complicated, complex and confusing program beyond the comprehension of most seniors. New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of Times columnist Paul Krugman Paul Robin Krugman (born February 28, 1953) is an American economist. Krugman, a liberal, is currently a professor of economics and international affairs at Princeton University. wrote (Register-Guard, Nov. 21): "The Medicare drug benefit is an example of gratuitous Bestowed or granted without consideration or exchange for something of value. The term gratuitous is applied to deeds, bailments, and other contractual agreements. privatization privatization: see nationalization. privatization Transfer of government services or assets to the private sector. State-owned assets may be sold to private owners, or statutory restrictions on competition between privately and publicly owned on a grand scale, ... and the result ... is a piece of legislation so bad it's almost surreal." Torrey fails to address the new plan's most important weakness - how it treats Medicaid recipients. Effective Jan. 1, Medicaid will provide only limited no-charge prescription drugs for anyone, except for those in nursing homes. Starting next year, most Medicaid recipients will be required to make copayments of $1 or $3 per prescription per month. It is not uncommon for some Medicaid recipients to require a dozen drugs or more every day. Their new monthly expenses in 2006 may be $20 or more. Medicaid residents of assisted living as·sist·ed living n. A living arrangement in which people with special needs, especially older people with disabilities, reside in a facility that provides help with everyday tasks such as bathing, dressing, and taking medication. facilities receive about $122 per month to pay for personal products, hair care, cable TV, The Register-Guard, pet food - and the list goes on. These people are already stretched to the limit. To now advise them that their monthly costs will go up $20 to pay for copays, for example, is a truly bitter pill to swallow (pun pun, use of words, usually humorous, based on (a) the several meanings of one word, (b) a similarity of meaning between words that are pronounced the same, or (c) the difference in meanings between two words pronounced the same and spelled somewhat similarly, e.g. intended). To obtain their medicine, they will have to give up something important to them such as their TV, their pet, etc. Financially secure enrollees will save hundreds, even thousands, of dollars. Why do the wealthy win, and the poorest of the poor lose? An important issue, now being ignored, is the fact that Medicaid residents will be required to make their copays literally out of pocket. Many such residents are experiencing dementia and can't remember their room number, much less where they put their money. Facilities are now facing the task of working out a system of cash control for residents. Some confusion exists about deadlines. It is possible to delay enrolling until May 15, 2006. However, no benefits will be available until the first day of the month following enrollment. Therefore, the most important deadline is Dec. 31. This is not a postmark deadline. It is important to allow at least one full week for mail delivery and processing by the selected plan. Help in understanding the new program may be obtained by calling the Medicare Access Network toll-free at (866) 329-0514. You will be advised about community-based group sessions leading to enrollment. The Oregon Health Insurance Benefits Assistance Program can be contacted at (800) 722-4134. Ignore the prompt to enter your ZIP code zip code System of postal-zone codes (zip stands for “zone improvement plan”) introduced in the U.S. in 1963 to improve mail delivery and exploit electronic reading and sorting capabilities. and enter "0." One-on-one assistance in community locations is available. Limited in-home counseling may be available for people lacking transportation. The Oregon Department of Human Resources The fancy word for "people." The human resources department within an organization, years ago known as the "personnel department," manages the administrative aspects of the employees. has a hot line at (877) 585-0007. Contact Medicare for information or to enroll at (800) 633-4227 or online at www.medicare.gov. Jerry Harden (mail4jah@clearwire .net) lives in a seniors-only community and is active in a variety of programs providing service to senior citizens. |
|
||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion