2006-01-11 / Features

Lawmakers Help Low Income Families Cope With Medicare Part D

Congressmember Joseph Crowley expressed concern last week about the troubled start of the new Medicare prescription drug program, calling special attention to some definite problems low income beneficiaries are having getting benefits to which they are entitled.

Eyeing the same problem, City Councilmember John Liu (D–Flushing) hosted a workshop on Monday to focus on the ways available for low-income families to secure financial aid to pay for the new coverage.

Further highlighting the problems with the benefit for this group, there were reports from Washington that some low-income recipients around the country were either denied service since the program started on January 1 or were overcharged for the service. Some state governments took steps to assist them.

Although the new program started on January 1, the deadline for initial enrollments is May 15. Anyone enrolling after that date will pay a penalty of one percent of the program premium for every month they are late enrolling.

In issuing his critique of the new program, Crowley (D–Queens/The Bronx) declared: “While this program can be helpful for some seniors, most have had to deal with a confusing array of choices, with very little clear advice.”

Regarding low-income seniors, he said Medicare Part D can save them money and help provide prescription drugs. But, “Unfortunately, implementation of the drug benefit has thus far run into some very definite problems, with low-income beneficiaries being some of the hardest affected being turned down for benefits they are entitled to.”

He advised anyone having difficulties to contact the Center for Medicare and Medicaid Services (CMMS) at 212-616-2222 or Crowley’s Queens office at 718-779-1400.

Crowley said that CMMS had experienced a nationwide problem which caused some low-income beneficiaries to be misidentified as ineligible for low-income subsidies.

When some have gone to their pharmacists, he said, some pharmacists understand that the beneficiary must pay an incorrectly inflated price.

Some who qualify are told they are not in the system or that it is not clear what their subsidy should be, the lawmaker said, and it causes pharmacies to turn them away even though they qualify as both Medicare and Medicaid enrollees.

A senior who qualifies for low-income subsidies, Crowley explained, should have received notification from the Social Security Administration and Medicare last summer or early fall. CMMS is working to correct the problem, he said, fixing individual cases as they arise.

“Unfortunately, there has been an incredible campaign of misinformation at CMMS on how this benefit works, which is making it difficult for some New Yorkers to get their medicines,” Crowley explained. He encouraged people affected to call the CMMS hotline or his office.

At Liu’s workshop, officials from the Social Security Administration (SSA) and the state EPIC program were available to provide information and assistance in filling out application forms for financial aid to pay premiums for the new Part D program.

Liu said anyone with limited income and resources might be able to get help from SSA or EPIC to pay for monthly premiums, deductibles and co-payments called for in the new drug program.

Liu explained, “If you already have Medicaid with prescription drug coverage and Medicaid, Medicare and Supplemental Security Income (SSI), you are automatically eligible to receive financial aid to pay for Medicare Part D premiums.

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