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Part D Medicare Plan Expected to Curb Drug Costs for Older Citizens

By TOM McCOURT
Sun Advocate reporter


RSVP workers are ready to help those who have questions on the prescription program.

Last month, Medicare presented the federal program's new prescription drug plan.

Enrollment began on Nov. 15, 2005 and will continue until May 15, 2006.

Benefits will start on Jan. 1, 2006 and millions of seniors are eligible for the program.

Unfortunately, there has been a lot of talk about how complicated the plan is and how intimidating the paperwork can be. But local help is available.

According to the Wall Street Journal, there were 36 million people in the United States last year ages 65 years and older.

Almost 91 percent of the older Americans rely on prescription drugs on a regular basis.

The cost of prescription drugs increased an average of 8.3 percent annually between 1994 and 2004.

Drug manufacturing is now the third most lucrative industry in the U.S. with a 16 percent profit margin.

Only mining and oil production rank higher on the nationwide profit list

Until now, Medicare did not pay for prescription drugs.

Under the new plan - called Medicare part D, seniors will be able to purchase private prescription drug insurance policies that are regulated and subsidized by the federal program.

The average monthly cost of the insurance premiums is expected to be about $32 per individual.

Under the plan, prescription drugs will not be free. There is still a co-payment required, as well as the monthly cost of a drug insurance plan.

However, the congressional budget office expects that the plan will save the average senior about 37 percent of the annual cost of prescription drugs.

Currently, the average Medicare recipient pays about $1,250 annually for prescriptions. Under the prescription drug plan, the cost is expected to drop to about $800, for a savings of $450 per year.

The U.S. Center for Medicare and Medicaid Services believes that the savings could be even higher for many people. But it depends on the number, type and dosage of drugs an individual is taking.

Ten nationwide insurance companies have joined the part D Medicare plan and there are many regional and local companies that offer policies. Currently, there are 2,183 individual insurance plans around the country that meet the government standard. In Utah, our range of choices is much smaller than that. The government subsidized program is expected to boost the profits of participating insurance companies between 2% and 4%.

The new plan is a major increase in the Medicare health benefit, and the cost is expected to be 700 billion dollars over the next ten years. President Bush calls it "the greatest advance in health care for seniors in 40 years."

Persons on Medicare are required to sign up and select a prescription-drug insurance policy before the May 15 deadline. The deadline is important. There are penalties for those who sign up late.

For those who receive benefits from both Medicare and Medicaid, the Center for Medicare and Medicaid Services has randomly selected an insurance policy for them. This was done to insure that no one would be left out when the new plan goes into effect on January 1. Seniors participating in both programs - Medicare and Medicaid - received a letter on yellow paper during the second week in November telling them which insurance plan had been pre-selected for them. However, the government-selected policy can be changed if the person prefers a different plan. Recipients are free to change the selection and pick their own plan if they choose. There is still the May 15 deadline to meet. If Medicare/Medicaid recipients are satisfied with the plan pre-selected for them, they don't need to do anything. A person is not required to choose another plan if they are happy with the one provided.

Retirees who currently enjoy prescription-drug benefits as a part of their retirement medical package, like UMWA retirees, most railroad retirees, and some others, do not need to apply for the new Part D Medicare plan if they received a letter from their insurance carrier stating that their plan is as good as, or better than the Medicare plan. Those people will stay with their company insurance programs.

Seniors are cautioned to be careful when signing up for a prescription insurance plan. Some insurance providers are actively recruiting customers and charging more in monthly premiums than is necessary.

Free local help is available for those seeking information or who need help in selecting a provider. The Retired Seniors Volunteer Program (RSVP) has an office in the Carbon Senior Citizens Center at 30 East and 200 South in Price. The RSVP program recruits, places, and helps to coordinate the efforts of individuals who are of social security age or older who wish to do volunteer work in the community. RSVP volunteers serve in schools, hospitals, Hospice, museums, etc. The RSVP program logs volunteer hours and encourages community recognition of volunteers as well as providing mileage reimbursement and supplemental auto, accident, and personal liability insurance to those who volunteer.

The RSVP staff has also been trained to coordinate the efforts of the Utah Health Insurance Information Program (HIIP). Someone is always available during working hours to assist in educating and enrolling people in the new Medicare Part D program.

Rebecca Mason, Tressa McArthur, and Shannon Heath, work at the RSVP center and they are happy to answer questions and help with enrollments. However, it is best to call for an appointment before stopping in. They are usually very busy. The Price office serves all of Carbon, Emery, and Grand Counties. The telephone number is 637-9118 locally, and 1-800-541-7735 for those outside of Carbon County.

For those wishing to select an insurance plan for the new benefit, the RSVP office has a computer program that will help a person make the decision. There are 46 different plans available to Utah residents, and the computer will select a person's three best choices depending upon individual circumstances.

RSVP staff asks that a person bring with them to the office their Medicare and/or Medicaid cards, a complete list of all drugs and dosages currently prescribed by a doctor, and all information about any additional health insurance a person may already have. The whole process takes about half-an-hour. Extra help is also available for seniors with very limited incomes and resources who might need assistance in paying the premiums to participate in the program.

Other places where information about the new program can be found are on the Internet at www.medicare.gov or by calling 1-800-633-4227. Persons familiar with computers can input and download the results of the same computer program that RSVP offers for selecting a Part D prescription-drug insurance provider.





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