Enrollment In Seniors’ Drug Benefit Program Off To Slow Start

Enrollment in the new Medicare prescription drug program for seniors opened last Tuesday, November 15 amid reports locally and nationwide that widespread misunderstanding about the new initiative was resulting in low enrollment members.

Lawmakers and senior advocates throughout the city and in Queens are trying to aid seniors in learning about program choices. Here in Queens, Congressmember Anthony Weiner (D–Queens/Brooklyn) is holding a meeting next Tuesday, November 29 at 1 p.m. at the Selfhelp Austin Street Senior Center, 106-06 Queens Blvd., Forest Hills, titled “The New Medicare Drug Benefit: Everything You Wanted To Know But Were Afraid to Ask.” Medicare experts will be on hand for a frank discussion about how to make the plan better, and booklets outlining options will be distributed. For more information, call Weiner’s office at 718-520-9001.

For those who did register, the program, designed to hold down seniors’ drug expenditures, is due to start on Jan. 1, 2006, about five weeks away.

Those who have not enrolled yet have until May 15 to do so and will be considered eligible for benefits from January 1, about five weeks away.

Those who enroll after May 15 will be assessed a penalty.

What caused the confusion with the program that resulted in large numbers failing to register by last Tuesday?

In brief, there is too much information to absorb, too many plans to choose among with no real clues as to which is best for an individual and which will provide all your medical needs at the lowest possible cost.

The trouble is, not all plans will give you all the medications that you are presently taking and there’s no way to find out because the insurance companies offering the plans have not announced which prescriptions they will cover. This is a major factor in creating confusion with choosing a plan.

Some basic facts about the program:

•It is voluntary—you don’t have to join; if you already have prescription coverage with your work retirement plan or from a previous employer and your present plan may be better, stick with it.

•There is a standard premium payment, $32 per month which will be deducted from your Social Security check; an individual must also pay a yearly deductible of $250.

•The individual pays 25 percent of the cost of the first $2,250 spent by any individual for prescriptions and the government pays 75 percent.

•The individual pays all of expenditures from $2,250 to $5,100, or $2,850. This is the so-called “doughnut hole.”

•The government pays 95 percent of expenditures over $5,100 and the individual pays 5 percent.

The maximum an individual must pay out-of-pocket for the new coverage is slightly over $4,000. You arrive at this figure by adding:

•Premium - $384 per year

•Deductible - $200 per year

•Members’ 25% share of first $2,250 - $562.50

•Members’ “doughnut” payment - $2,850.00

Total $4,046.50

However, keep this in mind: some plans are not charging a premium or charge less than the standard premium, and not everyone has the same drug costs; for some, costs are much less than others and will not come to $4,000 per year. For anyone presently paying over $4,000 out of pocket, the new drug plan will provide a savings.

New Yorkers have 46 plans to choose among and virtually every one of them has differences—differences in premiums, differences in deductibles and differences in drugs covered. The most important factor to figure in is your own level of drug costs. There’s a plan out there among the 46 which will fit you almost perfectly. You just have to work to find it.

For help, contact: Medicare gov, 1-800-MEDICARE (633-4227).

The American Association of Retired Persons (AARP) the national advocate organization for seniors, also offers help at www.aarp.org.

SENIORS’ SUBWAY SAVINGS: Seniors and the disabled, who now pay half fare for subway and bus rides, will get a further savings on weekends during the holiday season. The MTA announced last week that the price of a ride will be cut to 50 cents from November 24 to January 2. Private bus lines are also participating in the holiday fare cut.

Seniors will also save on a 40-day Holiday Unlimited MetroCard, which will be sold at the monthly card price of $76 and will actually be good for 41 days, from November 23 through January 2.

MALONEY’S SALUTE: Congressmember Carolyn Maloney (D–Queens/Manhattan), who’s been waging a major effort to prevent the Manhattan veterans hospital on East 23rd St. from being shut down by the Veterans Administration, and for restoration of full benefits for vets, said in a Veterans’ Day address recently: “I hope the [Bush] administration listens and remembers that you have made enormous sacrifices for our country and that young Americans on the battlefield today are still sacrificing. May God bless our veterans and their families. God bless our men and women in uniform, and God bless America!”

MEETINGS: Whitestone Community Post 4787 VFW will meet on Monday, November 28 at 8 p.m. at post headquarters, 19-12 149th St., Whitestone. PR Chairman James DiMauro writes that new members are welcome. For information, call 718-746-0549.

TANGO SHOW: The Wednesday, December 7 meeting of AARP Chapter No. 2889 at 12:30 p.m. at the First Presbyterian Church of Newtown, 54-05 Seabury St., Elmhurst, will feature a tango show by Robert Browne.