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Seniors Confused Over Medicare Part D

Each new day reveals more of the complexities of the Medicare Part D program. Seniors who need drug coverage are bewildered by the sheer volume of private insurance plans (more than 50 in some parts of the country), which makes comparison difficult.

Then there are the questions on how Part D affects employer-paid coverage, how it works with state-sponsored pharmaceutical assistance plans, how it affects people in nursing homes and how seniors with limited incomes can apply for "Extra Help."

At AFSCME headquarters, the Retiree Program has been bombarded with requests for Part D information from retiree leaders and individual members, along with union staff and elected officers who are trying to help their parents. Confusion is everywhere.

DEMAND FOR FACTS. Throughout the fall, in anticipation of November 15 — the starting date for buying Part D plans — the Retiree Program staff made every effort to help our members get answers to their questions. We sent every subchapter president a leaders' guide to Part D. We produced a slide presentation that we took to Retiree Chapter conventions and other meetings. We put Part D information on our web site.

In some cases, members easily found the answers they needed. In others, there don't seem to be any answers yet, even though the benefits start on January 1. The bottom line is that Medicare Part D is still a work in progress.

On page 3, you'll find a whole series of questions and answers about Part D. They should help a lot of our retiree members sort out the facts.

AFSCME retirees who are fortunate to enjoy drug coverage provided by employer, union or pension fund plans should have already received a notice of "creditable coverage," — which means your plan's drug benefit is at least as good as Part D. With creditable coverage, you won't have to pay a premium penalty if you need to join Part D in the future.

PREMIUM PENALTY. Everyone else has until May 15, 2006, to sign up for a Part D plan. Part D is voluntary, but if you're Medicare eligible and don't sign up by that date, you'll have to pay a penalty if you sign up later on. For every month you delay joining a plan, premiums will increase by one percent.

Because of the confusion, AFSCME is supporting S. 1841/H.R. 3861, the Medicare Informed Choice Act, introduced by Sen. Bill Nelson (D-FL) and Rep. Pete Stark (D-CA). It extends the initial sign up period to the end of 2006, giving everyone more time to decide on Part D plans without incurring the premium penalty. The bill would also allow seniors to change plans within the first year if they think they made a bad choice (current law says you have to keep your plan until 2007).

INFORMED CHOICE BILL. The Nelson/Stark legislation also includes an important safeguard for retirees with employer, union or pension fund coverage. It would prevent these plan sponsors from dropping coverage for retirees who sign up for Part D without the sponsor's permission (a big mistake). If this occurs, current law allows employers (or unions or pension funds) to cancel the retiree's entire health care package.

 

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