Time is running out

Comments have been made, asking me to write a column about Medicare Plan D. That has been done already three times, or at least about the changes which took place this year in Medicare. There have been more changes in Medicare this year than have ever occurred since the beginning of the program. It has not all been well; still it has not all been bad.

The open enrollment for the Medicare Advantage Programs and the Prescription Drug Program will end on May 15, less than a month away. There are those in Congress who want to extend the open enrollment period, including our Congressman Ike Skelton.

Because of the vast amount of confusion and a lack of knowledge, there is justification in this desire. Still, would it be fair for those who have already enrolled because they wanted to get done before the final enrollment day? The next open enrollment will be Nov. 15 to Dec. 31, 2006.

Monday of this week there were two USATODAY.com articles, one positive about the prescription program and the other negative. The article "Plan D needs extension" was written by Brad Woodhouse, communications director for Americans United, an advocacy organization based in Washington. He said, "Medicare Part D is so hopelessly flawed that the enrollment deadline of May 15, must be extended to give Congress time to fix this debacle."

The deadline also must be extended to give people more time to sign up without penalty. It would be immoral to penalize seniors and the disabled for their failure to sign up for a plan that should have never been this difficult and confusing in the first place.

The other article, "Views of Medicare plan shift," indicates another view. According to this article there are 7 million signed up, about half of those eligible. There are 400,000 joining each week.

Stated in the article, "Nearly two-thirds of enrollees said the program saves them money, a Washington Post/ABC News Poll found. An AARP poll found 78 percent are satisfied with the benefit. Complaints are way down; waiting times to get through to 1-800-Medicare operators average less than two minutes.

"Competition among plans has driven the average monthly premium down to $25 from the initial $37 estimate. The typical senior who previously lacked coverage will save an average of $1,100 annually, the government estimates a big number considering that many seniors without coverage have to choose between groceries and medicine."

It suggested that there may have to be an extension on the May 15 date, but it should be only for a brief period of time.

It is a little like getting the Income Tax in on time, when the closer it gets to April 15, the faster the clock seems to go and many people are facing the deadline.

The next few days will be a busy time for Medicare enrollment. If the wait is too long, the enrollment may not get in on time. Those going by mail have to be postmarked by May 15. Participants not enrolled by the final date will have to wait until the next open enrollment.

One in eight taxpayers file the final week before April 15th. Enrollment for Plan D in the final week will have a high rate of those eligible to enroll.

Any enrollment after next month will be penalized 1 percent of the premium per month. The penalty is not what the company might charge for premium, but based on the original premium of $35. This proves to be 35 cents per month. If you wait several years and then enroll, the penalty will add up to a costly amount.

For many participants, the new program is working great. It is especially good for those who qualified for having their premium paid for them, and those who qualified to have low co-pays on prescriptions, generally no more than $5. Many of these people have had difficult times and the new Medicare program is working great for them. One lady told me that she is saving about 50 percent on her medication.

There has been much frustration for many people; including Medicare participants, medical people and pharmacists. This is especially true at the beginning of the year. Most of the problems that occurred at that time have been corrected and the program is apparently working smoother.

People were told that if they enrolled by Dec. 31, their prescription drug card would go in effect the first day of January. Yeah, they went into effect, but getting the prescription was impossible. There were extremely long waits when calling the insurance companies that handled the program.

Many Medicare beneficiaries enrolled in a company that did not provide their medication and could not get the medication they needed. Many of the pharmacists and the states stepped up to the bat to put a temporary fix on many of those problems.

To help prevent numerous problems, the companies are suggesting that enrollment be completed by the 15th of the preceding month that they are to be effective. This has been helpful in preventing several of the problems that occurred earlier. In general, the program apparently is working better than many expected it would.

Any program that is this big, with all of these changes, is certain to have many problems. And there are still problems that need to be corrected.

If a Medicare participant is enrolled in an insurance program that is equal or better than the Medicare Plan D, they will not be penalized when enrolling later in the PDP.

As most of us mature, we find ourselves on more medication -- we do not know if this will happen or not.

To be on the safe side and to avoid a future enrollment penalty, consideration might be given to selecting a plan with a low premium. For example, one company offers a plan for a monthly premium of $10.29. If you are currently enrolled and have not made any changes since Jan. 1, you can change companies or plans once before May 15. When open enrollment comes at the end of the year, you will want to do some evaluation and determine if you are enrolled in the best plan for you, or need to enroll in a different plan.

For those on a high amount of medication, it may not take long to reach to what is referred to as the "donut hole."

The plan was designed for the beneficiary to pay 100 percent of the cost for medication. This occurs after a total of $2,250 has been paid by both the member and the company. It remains at this amount until $3,600 has been paid by out-of-pocket. When the final figure is reached, then the amount paid is really small for the beneficiary. At least one company will pay on the medications during the "donut hole" and at least one other will pay on the lower cost generics.

The decisions for older citizens and their adult children must be made soon.