Enrollment begins for Medicare Part D
Seniors looking to physicians, pharmacists for info
Seniors finally had the opportunity to enroll in a Medicare Part D plan beginning Nov. 15. More than half of those eligible, however, still are confused about the government’s new prescription drug plan benefit, according to a Kaiser Health Poll Report conducted in August.
Seniors must sign up for a Medicare Part D plan by May 15, 2006, to be eligible for coverage in 2006. Those signing up in 2005 would be covered under their plan beginning Jan. 1, 2006. After May, the next opportunity to enroll would be Nov. 15 to Dec. 31, 2006.
Plans have begun marketing to seniors, and Medicare is trying to set up a one-stop source of information about the prescription drug plan benefit and its participating plans on its web site, www.medicare.gov.
The survey from the Kaiser Family Foundation in Menlo Park, CA, shows mixed feelings about the benefit, which should pay half of a senior’s drug costs, according to the Medicare web site. More than six in 10 (65%) of the seniors surveyed say it will be "somewhat" or "very" helpful for a typical person on Medicare, and even more think the benefit will be helpful for people on Medicare with very high prescription drug costs (75%) or no drug coverage (74%) and for low-income people (70%).
However, they are less sure the benefit will help them personally. Twenty-two percent say the benefit will be "very" helpful, while more than three in 10 (35%) say it will not be helpful at all to them personally.
The survey also found gaps in seniors’ understanding of the benefit. Currently, about six in 10 seniors say they do not have a good understanding of the new benefit, and do not have enough information to understand how the new benefit will affect them personally (62%).
More than half (55%) of seniors seem to recognize that they need to sign up to receive the new Medicare prescription drug benefit. Just more than one in seven (15%) seniors believe that coverage will begin automatically, and about three in 10 (31%) don’t know.
A lot of seniors had not made up their minds to enroll, according to the survey. More than two in 10 (22%) seniors say they plan to enroll for the new benefit, more than double the share that said the same in April 2005 (9%). However, four in 10 seniors have currently not decided whether to enroll in the new prescription drug benefit, and one-third (33%) say they will not enroll.
More than half of the 73% of seniors who say they will not enroll, or who haven’t heard enough to decide whether to enroll in a Medicare prescription drug plan, say they already have help paying for prescription drugs from an insurance plan or program (55%). Other reasons include that they don’t think a Medicare drug plan will save them money (42%) or they don’t know enough about the new benefit (41%).
Of special note in the survey, nearly half of seniors (49%) said they would be "very" likely to turn to their doctor for information, and one-third said they would turn to their pharmacist (33%).
Helping patients navigate their choices
Pharmacists, however, can be confused about the benefit and its plans, too. That is why pharmacist organizations such as the American Pharmacists Association (APhA) in Washington, DC, have offered information resources on its web site (www.aphanet.org).
"With anything this big, both patients and health care providers will be faced with challenges," says Kristina E. Lunner, APhA’s director of federal government affairs. Some of the confusion has been that the Medicare web site, with its Drug Plan Finder and Formulary Finder features, has not totally been updated with the detailed information about each participating plan.
"There is also a lot of confusion about whether seniors should sign up," Lunner says. "There is a lot of going on — that’s the bottom line."
The prescription drug benefit is for outpatients. However, hospital pharmacists also need to have familiarity with local Medicare Part D plans.
"Physicians and pharmacists who are working with patients in the hospital will need to be cognizant of what medications the patients’ Part D plan covers for them when they are released," explains Susan K. Bishop, MA, APhA’s associate director of regulatory affairs.
"Pharmacists in general won’t have all the formularies memorized because there are so many Part D plans in each region," she continues. Pharmacists, health care providers, or even consumers should instead be able look up the individual plan on the Medicare web site and get the formulary information from the Formulary Finder feature.
The more familiar pharmacists become with the plans in their area, the better equipped they will be to answer questions from their patients, Lunner adds. She suggests that pharmacists use the Formulary Finder feature to identify the top 20 or so drugs they dispense to Medicare beneficiaries right now. "The results will give them a quick reference as to which plans cover which drug."
Seniors finally had the opportunity to enroll in a Medicare Part D plan beginning Nov. 15. More than half of those eligible, however, still are confused about the governments new prescription drug plan benefit, according to a Kaiser Health Poll Report conducted in August.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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