Drug program leaves consumers confused

A Medicare prescription drug program that started Jan. 1 has caused nationwide problems as it seems to be creating consumer confusion, requiring people to choose from dozens of competing private insurance plans. (Staff photo: Eric Kluth)

By Andy Jackson and Kevin Wilson

Consumer confusion reigns as the new Medicare prescription drug program starts up.

The program, which began Jan. 1, requires people to choose from among dozens of competing private insurance plans.

The most needy people in the program have a specific plan chosen for them initially; while those with higher incomes have to pick one.

Sue Davis, 55, of Clovis, falls in the first category.

“I need coverage,” said Davis, who lists high blood pressure, diabetes, and strokes among her ailments. She said she takes 20 pills a day plus insulin. “I don’t know about my options because they have so many prescriptions. I don’t know who will cover all the prescriptions I need. The people at La Casa (health center) said they’ll look into it.”

Falling in the second category, of higher income seniors who must choose their own plan, Pete Soots, 75, of Clovis experienced similar problems deciphering the multitude of plans available. He said he asked for help at Wal-Mart and Walgreen’s and was handed a couple of pamphlets.

“They don’t know more than I do,” Soots said. “There’s so much involved with it. The government is still trying to sort it out. How do they expect us to make good decisions when they can’t?”

Soots said after reading about seven plans, he chose one based mostly on the premium, which is $130 per year.

“What drugs they cover and how much it will run appears it will be better than before,” Soots said. “Whether that’s true remains to be seen.

“With all companies advertising by mail and the Internet, it seems all prices will change yearly. I don’t know if that will be something people on fixed incomes will benefit from,” Soots questioned.

Medicare recipients have until June 15 to sign up for 2006.
Clovis Mayor David Lansford, a pharmacist of 24 years, is concerned the plan will become a heavy burden to taxpayers.

“I’m sure a lot of customers will find this a good deal to them,” Lansford said. “But it comes at a cost — these prescriptions aren’t cheap.

“I’m concerned that we’ve started something that in years to come will be very costly to the taxpayers.”

With more than 40 plans to choose from, the burden of educating the customer has been put on pharmacists, Lansford said — even though pharmacists are not allowed to sway customers to a specific plan.

“There’s probably as many as 40 options (plans) in New Mexico,” Lansford said. “People are confused about what to sign up for, and we (pharmacists) are prohibited from advising on specific plans,” he said.

Roosevelt General Hospital Administrator James D’Agostino makes available as many pieces of information as possible to customers, ranging from pamphlets to Web sites to magazine and newspaper articles, he said.

“As we’ve gotten information, I’ve just distributed the information to employees,” D’Agostino said. “Once we get it down so it’s totally understandable, we’ll be a resource that people can call.”

D’Agostino said the plan was “extremely confusing,” but added an online questionnaire at www.medicare.gov is the best way to tailor an appropriate prescription plan. The best advice D’Agostino could give was to be thorough in looking for a plan and supplementary insurance offers.

“On the surface, it appears that (the new program is) going to be much better,” D’Agostino said. “It’s all in what your diagnostic needs are.”

Questions can also be directed to Centers for Medicare and Medicaid Services at 1-800-Medicare or http://www.cms.hhs.gov.

Medicare spokesman Gary Karr said millions of people are getting their prescription drugs through the new program, despite the glitches.

“We certainly acknowledge there have been some problems,” Karr said. “This is a $30-$40 billion program. It’s a big transition for many people.”

The Associated Press contributed to this report.