Health & Medical

Plan D, to Sign, or Not to Sign: What to do by May 15th

Here’s where the new Medicare Plan D stands two weeks before the sign-up deadline.

  • Contrary to government claims, somewhere between eight and 14 million seniors still haven’t signed up for Plan D.
  • Four in 10 seniors don’t even know about the May 15 deadline to sign up for Plan D.
  • Five in 10 don’t know that Congress imposed lifetime penalties if not signed up by May 15.
  • Choosing an insurance company is now even more complicated than it was on January 1st.
    • Drug formularies change daily, without notice.
    • Providers won’t disclose costs.
    • Social Security computers are jammed, daily rejecting thousands of applicants.
    • Co-payments widely vary, in one case (Enbrel) from $20 in one Part D plan to $1,276 in another.
    • Topping it off, many doctors are closing their doors to new Medicare patients.
  • Finally, tens of thousands of seniors who requested that Plan D premiums be withheld from their Social Security checks have received letters from their plans threatening termination for nonpayment.

What a sorry mess!

I’m getting 50 to 150 horror stories a day from readers unable to get the drugs and treatment they need from their Plan D providers. Read my e-mails and you’d think we were living in the poorest and most uncaring of third-world countries.

And while this needless suffering continues, our government tells us, with the flash and smile of a used-car salesman, to “enroll now and start saving.”

Just last week, citing Plan D’s “success,” our president professed that more than 29 million of us have already signed up for an average annual savings of $1,100.

Thing is, most of those signing up were either automatically enrolled or were not enrolled in a Part D plan at all. They received drug coverage elsewhere.

Lies. Delays. And Lies Exposed.

If you’re still holding out, let’s look at how you can best deal with this 1.2-trillion dollar fiasco.

Extended Deadline: Congress, the White House, and Medicare (Centers for Medicare and Medicaid Services) all claim there’s no way to extend the deadline. Yet CMS can, by law, extend it however it desires. In fact, CMS has already granted Hurricane Katrina evacuees more time to choose their Medicare prescription drug plan.

Of course, Congress also can extend the deadline. But democracy won’t come to Medicare as long as the same Republican leadership that brought us the Part D disaster prevents any legislation aimed at fixing the problems from coming to a vote.

Cost of Delay: To pressure everyone into signing by May 15th, the law exacts a permanent penalty of 1 percent a month on every month you wait beyond the deadline. If the deadline is not extended, you will end up paying 1 percent of the average national premium (now about $32) atop regular monthly premiums. For example, those opting to buy at the start of the next open enrollment in November face a permanent surcharge of about $2 monthly ($24 a year times the number of years you cling to this mortal coil).

Sign Up on the Cheap: It may pay to simply sign up for the cheapest possible premium, no matter the company’s current drug formulary. If you spend little or nothing on drugs right now, but you fear that down the road you’ll need to join a Plan D provider, this is the way to go. It may cost ten bucks or so a month, but it will definitely keep you in the game, without penalties.

Buy medicine at Costco or overseas; chances are it will be way cheaper than your plan.

PAPs: Until Plan D, drug manufacturers’ patient assistance programs provided needed medicine to millions of eligible seniors at little or no cost. Most companies killed their lifesaving programs claiming that it was illegal to give free drugs to anyone eligible for Part D.

T’ain’t true! And now that that’s out in the open, drug companies like Schering-Plough, Astra Zeneca, Wyeth and others apparently will continue to support their PAPs with seniors, but only if the patient has not joined Plan D.

RxOutreach: This outfit is new to me. A number of Suddenly Senior readers tell me that RxOutreach (800.769.3880), managed by Express Scripts, has low prices, depending on household income and population. Ninety-day supplies of Tier 1 medicines cost $20 – Tier 2 drugs go for $30 – including shipping and handling.

Generally, for a two-person household to qualify, income must be less than $33,000 a year.

Last week I wrote about Gloria and Russ Tuttle who feared that the Medicare drug plan might force them to divorce. Here’s what Gloria wrote me today…

We will not sign up for Plan D. And we will not get divorced. I believe now that the drug companies will come around and continue their lifesaving PAP programs. I can’t believe our government SO UNDERESTIMATES seniors. It must believe we are all old, stupid and senile. Russ and I received about 50 helpful responses to your column. Thank you one and all.

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