Government
Patients look to doctors for help on Medicare drug plans
■ Confusion reigns for seniors as Medicare drug programs begin the process of signing up beneficiaries.
By David Glendinning — Posted Dec. 5, 2005
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Washington -- Physicians who have not yet heard questions from their senior patients about whether or how to sign up for a Medicare drug plan may start hearing them soon.
The plans that have contracted with the federal government to offer drug benefits starting next year began signing up beneficiaries Nov. 15. But mere days before the enrollment launch, the Kaiser Family Foundation released a survey concluding that most seniors still didn't know what they would be getting into by joining a plan.
More than 60% of the seniors surveyed said they understood the upcoming benefit "not too well" or "not at all," according to the foundation. More than one in three seniors continued to have an unfavorable impression of the prescription drug coverage even after the months that federal officials and other groups spent promoting the new Medicare Part D. And many seniors who remain confused about what they should do are liable to turn to their doctors for help, the Kaiser survey found. Nearly one-third of seniors said they very likely would seek physician assistance in tackling drug benefit questions, and 65% expected their doctors to be very or somewhat knowledgeable about the plan choices that beneficiaries are facing.
All of this adds up to a tricky situation if physicians don't know what to tell their patients, said Mollyann Brodie, PhD, director of public opinion and media research at Kaiser.
"Many seniors expect to lean heavily on their doctors and pharmacists to help guide them through their many options," she said. "If this proves unrealistic, their frustration could create an implementation challenge."
From a certain standpoint, the Centers for Medicare & Medicaid Services was too successful in attracting private plans to offer prescription drug benefits to seniors and disabled people. When told that most people enrolled in Medicare will have 40 or more plan choices, nearly three in four beneficiaries said such variety would lead to only more confusion.
New tools for patients and doctors
In an effort to help relieve the widespread confusion about Medicare Part D, CMS recently launched several online tools on Medicare's Web site aimed at making sense of available drug plan options. Physicians can direct their patients to access the tools online.
Beneficiaries can use the Medicare Prescription Drug Plan Finder to compare the plan options in their area and to figure out how much they would cost. Seniors who want to enroll in one of the offerings can do so directly through the same Web site.
For those just looking for a ballpark figure on how much they would pay out of pocket for subsidized drugs, the Medicare Prescription Drug Plan Cost Estimator projects any annual savings that would result from joining a Medicare plan. The tool bases its figures on where a beneficiary lives and how much he or she currently pays a month for medications.
Patients or doctors who want to find out which plans cover a specific list of treatments can access the Formulary Finder for Prescription Drug Plans.
Surfers beware
CMS officials have been pushing the Web site as the first stop for beneficiaries with questions about enrolling. But some advocates for seniors and the disabled are warning that it should not be their last stop.
The Medicare Rights Center in New York, which counsels beneficiaries on the program, recently urged information-seekers to avoid using the prescription drug plan finder to make enrollment choices. Incomplete and inaccurate information about drug coverage and prices make for an unreliable tool, said Robert Hayes, president of the center.
"The tool is misleading at worst, useless at best, until it includes accurate information about what medications are covered by the drug plans," he said. The center also warned that the cost estimator and formulary finder could be misleading to users.
In addition, the tools will be of limited or no use to the more than three in four seniors who have never been online, said Ron Pollack, executive director of the consumer group Families USA. Beneficiaries without Internet access can receive the same information from 800-MEDICARE, but only through advisers who are accessing the tools themselves.
"It is clear that seniors will have a very difficult time wading through the fine print among dozens of plans," he said. "Seniors are bewildered by this complex program and, as a result, many will not enroll in the program."
CMS officials said they still were updating data on the Web site and on 800-MEDICARE in the days leading up to the Nov. 15 enrollment launch. Beneficiaries who want Medicare drug coverage starting Jan. 1 have until the end of December to enroll. Eligible seniors who do not sign up by May 15 could face penalties if they decide to do so during future open enrollment periods.