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

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

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.

Back to top


ADDITIONAL INFORMATION

Help wanted

Beneficiaries are seeking help in deciding whether to enroll in one of the Medicare drug plans, which started signing people up Nov. 15. A survey of beneficiaries shows the percentage who said they are "very likely" to look for assistance from these sources:

Medicare 33%
Doctor 32%
Pharmacist 25%
Social Security 24%
Friends or family members 20%
A local seniors group or
community organization
16%
Medicaid 14%
A former employer or union 9%

Source: Kaiser Family Foundation survey, November

Back to top


External links

Centers for Medicare & Medicaid Services on the Medicare drug program (link)

"The Medicare Drug Benefit: Beneficiary Perspectives Just Before Implementation," Kaiser Family Foundation survey (link)

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn