OK Emergency Coverage For Seniors Without Medicare Part D

The new Medicare Part D prescription drug subsidy program, which got off to a shaky start, continued to make news last week ranging from emergency protection for the elderly and disabled who have not yet been able to get into the program to calls that the system be scrapped, a proposal made by United States Senator Hillary Rodham Clinton.

In between, it was reported from Washington that, because seniors are choosing plans with lower premiums, the federal government’s cost of administering the program may be 20 percent less in its first year.

The emergency coverage is provided in a bill passed by both the Assembly and senate last week in Albany.

The bill, which is awaiting Governor George Pataki’s signature, would ensure that Medicaid coverage for prescriptions would continue to be provided to eligible individuals under Medicare Part D and Medicaid, according to state Senator Frank Padavan

R–C, Bellerose).

The emergency coverage would continue until the state’s health commissioner certifies that operational problems associated with the new program are resolved, Padavan said.

The lawmaker said that the new federal drug subsidy program, which started January 1, was beset with many problems that left thousands of seniors scrambling to get their required medications.

“The concern is that hundreds of thousands of New Yorkers will be left without prescription drug coverage,” Padavan stated. “This is a health care crisis of grave concern.”

According to Assemblymember Ivan Lafayette (D–Jackson Heights), 600,000 seniors in the state were placed at risk when the new Medicare Part D program started.

Those 600,000 people are on Medicaid, which provides prescription drug coverage, and were to have been switched to Medicare which, in the future, would provide the drug coverage.

But bureaucratic foulups kept many from being switched to Medicare and some whose coverage was changed to Medicare ran into complications from the insurance companies whose plans they were enrolled in. The companies raised questions about eligibility and refused to authorize pharmacists to fill prescriptions. However, in many cases the druggists filled the prescriptions anyway, realizing that without them, seniors’ health and even their lives could be placed in jeopardy if they were cut off from their medication for any time.

CLINTON’S SOLUTION: Last Thursday Clinton, speaking at a Senate Health Committee hearing in Washington, reviewed the major problems encountered as the new Part D program got underway and demanded that it be scrapped. The lawmaker didn’t say what would replace it.

Senator Rick Santorum, a conservative Republican from Pennsylvania, responded that the suggestion was “beyond the dignity” of the Senate. Clinton shot back: “I think the Congress should worry less about its dignity and more about the health care of the people.”

Also during the committee hearing, Mark McClellan, who runs the Part D program as well as Medicare and Medicaid in the Bush Administration, announced that a temporary coverage program for seniors having problems getting their medications was being extended 60 days.

Addressing the program’s shaky start, McClellan said, “A change this big in a short period of time is bound to have some problems.”

COSTS DROP: Also last Thursday, McClellan reported, “People are tending to sign up for less expensive plans.” The government’s cost for the program this year consequently will be 20 percent less than estimated, saving the government $7.6 billion.

Officials said that the program premiums to be paid by each member, first predicted to average about $37 a month, are actually coming out to $25 a month.

Insurers are offering a number of different plans to seniors, as many as 40 in every state. Many seniors have been able to choose the ones with the least expensive premiums. On the other hand, so many programs made choosing the best program for themselves difficult for seniors.