Mistaken Medicare letter gives senior citizens a dose of confusion

DECATUR - A glitch prevented a seamless Medicare prescription drug transition for thousands of Illinois senior citizens enrolled in SeniorCare, including as many as 30 Decatur-area residents.

Roughly 20,000 to 30,000 people enrolled in the state's SeniorCare assistance program mistakenly received a letter from the federal government telling them they had been automatically enrolled in a Medicare prescription drug plan, said Kathleen Strand, spokeswoman for the Illinois Department of Healthcare and Family Services.

Now the state agency is working with the regional office of the U.S. Centers for Medicare and Medicaid Services to narrow the problem and tell the seniors how to proceed.

The snag is suspected to have happened during the exchange of information between the state and the federal agencies, according to Greg Chesmore, a U.S. Centers for Medicare and Medicaid Services spokesman in the Chicago office.

"We believe this is a very small number of beneficiaries who were accessing prescription drug benefits through SeniorCare and Circuit Breaker," he said. "We're in the process of identifying those."

Strand said as far as the state knows, the problem is limited to about 10 percent to 15 percent of the 200,000 seniors enrolled in SeniorCare. People in the program should not have been automatically enrolled in a Medicare Part D plan.

The people who are supposed to be automatically enrolled are those who called "dual-eligibles," meaning they qualify for the state Medicaid and the federal Medicare benefits.

Confusion struck about 30 seniors who showed their letters to the Decatur-Macon County Senior Center last Tuesday, according to director Gail Poundstone. "People may get these and think, 'Well, I guess I'm stuck with this," she said. "They're going to be put into a plan and then say, 'Oops, I'm not eligible for it.'"

To help clarify, the state's Department of Healthcare and Family Services will mail another set of letters to the appropriate subset of seniors telling them to ignore the federal letter, Strand said. The state's letter will accompany a pre-enrollment kit from two companies - UnitedHealth Group and PacifiCare Health Systems - that contracted with the state to accept automatically enrolled people.

"We're going to leave no stone unturned to make sure these people are brought into the correct programs," Strand said.

Chesmore of Medicare and Medicaid services said the best plan for seniors is to avoid panic and wait until they receive the state's letter telling them whom to contact if they have questions.

"Even though (the letter they received) says CMS will enroll them in the plan, the state action will ultimately trump the federal letter," Chesmore said. "There will be no negative effects on the beneficiaries, but we understand this has caused confusion."