UCSF Pharmacy Experts Offer Medicare Part D Prescription Drug Plan Advice as Deadline Looms
by
Jeff Miller
In
our last story
about Medicare Part D, Marilyn Stebbins, clinical professor in the UCSF School
of Pharmacy, offered an independent, frontline perspective on how the new drug
insurance plan was then unfolding. With less than 30 days before the May 15,
2006 sign up deadline, Stebbins, who has been busy conducting education and
enrollment sessions with seniors all over northern California, and her colleague
Tim Cutler, assistant clinical professor in the UCSF School of Pharmacy, answer
this latest round of Medicare Part D questions.
Have most eligible seniors now signed up with a drug insurance plan?
And among those who haven't, are there any population groups that seem more
reluctant or unable to do so? Why?
Of the 43 million Medicare-eligible patients, the US Department of Health
and Human Services estimates that 39.1 million will have creditable drug
coverage in 2006. It is estimated that 29.3 million of these enrollees would
be enrolled in a Part D plan, and that 10 million of these enrollees would
have creditable coverage through an employer or union. As of March 1, 2006,
17.9 million of the 29.3 million have enrolled in a Part D plan. The majority
of those that have enrolled have had facilitated enrollment. Only 6.4 million
beneficiaries have actually signed up for a Part D plan on their own. This
leaves another 11.9 million who have not enrolled, but are eligible.
For the March 2006 Medicare Prescription Drug Coverage Enrollment Update,
go here (pdf).
Of these 11.9 million beneficiaries who have not yet enrolled, cultural
barriers, where there is a lack of trust in government, and language barriers
may play a role. The majority of outreach programs and materials produced
have been in English. There are also those who are just too confused by
the enrollment process (Internet or 800 telephone numbers) and the large
numbers of plan choices and options.
What is the best way to reach the unregistered before the May 15
deadline? Is the UCSF School of Pharmacy making any special effort to do
so?
Pharmacies are making a huge effort to reach Medicare beneficiaries before
May 15 with mailings and incentives to come in and talk to the pharmacist
about a Part D plan. The UCSF School of Pharmacy, in particular, has been
conducting Medicare outreach programs to assist patients in the decision
and enrollment process. Many of the areas that have been targeted include
underserved, low-income communities. An upcoming outreach program will be
offered in five languages - Mandarin, Cantonese, Russian, Spanish
and English - with one-on-one sessions to assist these individuals
with their plan choices and to ensure that they are getting any extra help
for which they may be eligible.
What are the penalties if someone misses the May 15 deadline, and
how are the penalties calculated?
If you are told that you are eligible for Medicare Part D and you do not
join by May 15, you will be assessed a penalty AND you may not join a plan
until the annual open enrollment period the next year (November 15-December
31). If you join at a later date than when you were eligible, you will be
assessed a penalty of 1% per month of missed enrollment. The penalty is
based upon the national average premium in the year the patient signs up.
Here is an example:
You decide 4 years after you become eligible for Medicare to join a Part
D plan. That year, the national average premium is $50.
- • 4 years of missed enrollment adds up to 48 months x 1% = 48%.
- • 48% of $50 (the national average premium that year) = $24.
- • $24 is added to the premium that the patient chooses that year.
- • If the plan the patient chooses has a $15 premium, the patient will pay $39 each month that year, instead of $15, due to the penalty.
- • This penalty is recalculated every year, based on that year's national average premium, and added to the premium of the plan that the patient chooses that year.