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Jan. 16, 2006 issue - Computer crashes, jammed phone lines, longtime prescriptions no longer covered—but also a lot of prescriptions smoothly and rapidly filled. That was the look of the new drug benefit known as Medicare Part D, which was launched last week. Glitches are frustrating, of course. But helpful pharmacists, plus transition rules, have kept the medicines flowing while problems are sorted out.
A much larger problem lies ahead: persuading seniors to sign up. On paper, the early numbers look good. Part D is serving 11.6 million people. But most of the plan's first customers—10.6 million of them—aren't volunteers. They're clients of Medicaid, the state-run health program for the poor. At the end of last year, the government switched them to Medicare for prescription drugs. Assignments were random. An equal number of bodies went to each of the lower-cost plans in a local area.
That explains the confusion. Some people had no idea that their insurance had changed. Some wound up in plans that didn't cover drugs they use. They'll have to change prescriptions or get new plans. Doctors, families and druggists can help.
The challenge, now, is attracting the 20 million seniors with little or no prescription-drug insurance. For them, joining a plan is a matter of choice and, so far, only 1 million have signed up. Medicare hopes for at least 10 million more. Part D needs them for its own financial health. They pay monthly premiums (Medicaid clients don't). Part D also needs seniors who have only modest drug expenses. If participation skews toward those with the highest bills, future premiums will rise to higher levels than the government expects.
The question, then, is whether Part D has value, and for whom. Two types of plans are on offer—stand-alone plans that cover only prescription drugs and managed-care plans (called Medicare Advantage), where a network of doctors delivers all your health benefits, drugs included. Some consumer tips:
If you're in a Medicare managed-care plan, stay there. Drug benefits have been added automatically. If a salesperson talks you into joining a separate Part D plan, you'll be dropped from managed care and enrolled in regular Medicare.
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