MEETING ENROLLMENT CHALLENGES HEAD-ON
Guest opinion submitted by Idaho Senator Mike Crapo
â??At present, two worries are paramount. That despite publicity and government educational efforts, many of those participating remain in the dark about what it will and will not coverâ?¦As to the first problem, it is perhaps unavoidable that some persons remain uninformed despite good intentions and earnest efforts. Whatever the arguments have been and will be against it, Medicare deserves a fair trial.â?? San Angelo Standard-Times This observation is a little dated--almost forty years to be exact. In July 1966, when Medicare was first implemented, this quote reflected national concern with the then-new program--that publicity and outreach efforts by government and industry would not sufficiently inform people about details and process. When considering challenges encountered in the new Medicare Part D prescription drug program, itâ??s easy to forget that the parent program, now used by over 42 million Americans, had start-up glitches as well. The new Medicare drug program is the largest federal entitlement program to be enacted in four decades. Any time the government undertakes a project of this magnitude, complications will arise. And alarm over problems can obscure good news--as of January 19, 84,000 of the 193,000 Medicare-eligible beneficiaries in Idaho were enrolled under the new Medicare Part D. The Idaho Department of Health and Welfare, together with local agencies and organizations, currently have 173 sites statewide to help educate and enroll Idaho seniors in the new program. Challenges remain. I know about confusing new co-payments and formularies, tied-up phone lines and malfunctioning computer systems. These problems are unacceptable and improvements are being implemented. I have been in contact with numerous groups affected by these issues and am working with Centers for Medicare and Medicaid Services (CMS) to apply solutions. The current enrollment period ends May 15, so if you or a loved one has not yet signed up for the prescription drug benefit, there are many resources to help you do so. The drug plans might seem complicated at first glance, but with some time devoted to research, recipients will find a plan that will save money. As we go into the second half of February, itâ??s important to remember that the best time to enroll is the first part of the month. The following information may help:-Twelve insurance plans offering coverage in Idaho have prescription drug plans with no premium for beneficiaries who qualify for extra assistance.-All plans meet Medicare requirements for access to medically-necessary drugs, access to convenient retail pharmacies and access to drugs for those in nursing homes.-All plans are required to meet the minimum Medicare standard which covers an average of 75 percent of drug costs after a $250 deductible up to $2,250. The coverages also pay 95 percent after $3,600 in out-of-pocket costs.-The Senior Health Insurance Benefits Advisors (SHIBA) organization has trained volunteers to help with questions about health insurance, benefits, and health care and prescription access. The number is 1-800-247-4422.-Both the website www.medicare.gov and Medicareâ??s 24-hour toll-free number 1-800-633-4227 (I-800-MEDICARE) have information to help beneficiaries discover the plan that is right for them. -The Idaho Care Line at 2-1-1 can answer any questions as well. Itâ??s important for the families, friends, and even neighbors of Medicare beneficiaries to also examine the new offerings. The advice of loved ones is invaluable in this process, and can help beneficiaries select the appropriate plan. If you have questions, please contact any of my offices; my staff is ready to help. Changes can be challenging but, in this case, the end result will be more responsive health care for all.