Medicare deadline is Monday

Drug coverage will cost more later

Lee Bowman, Scripps Howard News Service

Published May 13, 2006 at midnight

Text size

More Health Care

More stories »

WASHINGTON - A six- month roller-coaster ride for America's seniors concludes Monday - the last day to sign up for Medicare prescription drug coverage without financial penalty.

About 10 million people likely will have signed up, meaning roughly 90 percent of the Medicare population will enjoy coverage from some source.

In Colorado, the official enrollment figure is 417,000 out of 522,000 seniors. But that doesn't include working seniors, veterans and people with coverage through the Indian Health Service. Including those people raises Colorado's enrollment figures, approximately, to 480,000.

This is a historic level of enrollment for a new government program, according to Health and Human Services Secretary Mike Leavitt.

But the massive $1.3 trillion benefit has been a work in progress as bureaucrats have tinkered with flaws and struggled to assemble a competent work force of telephone and in- person counselors able to guide thousands of seniors daily through menus of up to 40 possible plans.

Outside government investigators reported that they were given incomplete and sometimes wrong information from the 1-800-MEDICARE operators most of the time they called the hotline several months ago. Medicare officials insist the program has gotten better since then.

"The first few months of the program's implementation was widely acknowledged to be a mess," said Judith Stein, executive director of the Center for Medicare Advocacy, one of many advocates who urged that the May 15 deadline be extended. "People need time to get over that rocky start."

The government has sponsoring more than 1,000 enrollment events around the country this week, and advocacy groups have set up thousands more.

"We're seeing more organizations that want to get us out and more traffic at the events we're doing," said Wendy Zenker, outreach director for MyMedicareMatters, a program sponsored by the National Council on Aging and the Access of Benefits Coalition.

Zenker said she's noted, along with other outreach organizations, that more children, grandchildren and other family and friends of the elderly are getting involved in the final week as they try to help seniors who may have been too confused to navigate the process on their own.

Background noise for the individual, personal decisions that Medicare beneficiaries have to make has been provided by scores of reports from critics and advocates of the program about how many or how few are covered, how good or how weak the benefits are, and whether the neediest seniors are getting help.

Foes regularly find seniors confused by the plans; proponents cite surveys that show most beneficiaries like the coverage and that they're saving money.

One report, issued Tuesday by the health advocacy group Families USA, claimed that fewer than one in four low-income seniors eligible for special drug premium subsidies have signed up for them, and that another 6.3 million people who formerly had drug coverage under Medicaid are now paying more in drug co-payments than they did before.

HHS came back Wednesday with new figures that showed all but about 3 million of those eligible for "extra help" in the form of zero or reduced premiums and low co-pays have coverage either through new or existing programs.

"We're trying to concentrate the additional dollars on beneficiaries that need the help the most," said Medicare administrator Dr. Mark McClellan.

Enrollment for low-income people is, the government admits, more cumbersome than other Medicare claimants because they have to fill out a form to verify to Social Security officials that assets and income don't exceed a threshold and then move on to choosing a drug plan.

That's why the enrollment deadline for this group has been extended indefinitely beyond Monday, without any financial penalty, the administration announced earlier this week.

"It's a hard-to-reach population," McClellan said.

Anyone who doesn't meet the low-income and asset threshold and seeks to sign up for a plan during the next enrollment period that begins Nov. 15 will face a penalty based on a seven-month delay.

The penalty is supposed to equal 1 percent of the national average premium for each month an eligible beneficiary goes without drug insurance. With the national average monthly premium now at $33.50, that means those who miss Monday's deadline would face a minimum surcharge of $2.31 a month on their drug premium for the rest of their lives.

While officials from President Bush on down insist there will be no more extensions, many lawmakers, including key Republican leaders, say unofficially that they're looking for a way to waive the penalty for stragglers at all income levels during at least the next enrollment period.

Subscribe to the Rocky Mountain News