A senior moment

Flawed and costly, new Medicare drug plan is all there is for now

Enrollment begins today for the new Medicare prescription drug benefit. Many seniors have been put off by the daunting complexity of the program.

They have the impression that you need a Ph.D. to understand the benefit, the skills of a teenage computer whiz to navigate the online information sites and the patience of a saint to wade through all the possibilities.

Well, that would certainly help.

The good news is there's no rush.

The most important advice for seniors right now is: Take your time.

Anyone who signs up for the Medicare Part D prescription drug benefit by Dec. 31 will receive coverage from the time the plan begins, on Jan. 1.

The deadline for enrolling without penalty isn't until May 15.

Lupe Solis, AARP Arizona's associate state director, is telling Arizona seniors to "go over and over" the options.

"By taking your time," she says, "you will be able to find out nuances."

And there are a lot of nuances.

Congress created a deeply flawed program of fiendish complexity with a price tag that is headed through the roof - 10-year estimates exceed $700 billion.

Congress didn't set a federal standard for Medicare Part D, leaving participants to choose among a wide variety of plans offered by private insurers that contract with the federal government.

Seniors can take the drug coverage as part of an overall Medicare health plan or they can choose a separate plan.

In Arizona, 19 companies are offering more than 40 plans. AARP has one, although Solis says she doesn't advocate any program in explaining the new Medicare benefit.

The variables include the annual deductible, the monthly premium and the co-payment for your medications.

An extra complication, intended to hold down costs, is the "doughnut hole." After your drug costs reach $2,250 for the year, you pay the full cost of medications until your total bill hits $5,100. Above that level, you pay 5 percent of the cost.

Low-income Americans are eligible for more comprehensive coverage.

Comparing prices takes far more than a little multiplication.

Medicare has done its best with a Web site that includes the nifty "Medicare prescription drug plan finder," which lets people compare plans based on the prescriptions they actually use.

But the results could still have seniors reaching for an dose of blood-pressure medication: A search for plans in central Phoenix, based on using four common medications, turned up 38 possibilities, which required eight electronic "pages" to display.

Medicare also has a toll-free number for those without Internet access.

To prod seniors into Part D coverage by May 15, there's a cost increase of 1 percent for each month they delay in enrolling beyond that date.

But here's another twist: Many retirees receive prescription drug benefits as part of the medical coverage from their former employer. Some companies say they'll drop all medical coverage for retirees who enroll in Part D.

But what if the company later bails out of drug coverage? Companies were required to send letters stating whether their prescription drug plans are as good as Part D or better. Retirees will be able to avoid the penalty for late enrollment in Part D if they show the letter.

In his weekly radio address Saturday, President Bush hailed the new prescription drug benefit as "the greatest advance" in health care for the elderly since Medicare was created 40 years ago. He urged Medicare beneficiaries to enroll.

As an advance, Part D takes some very wobbly steps, stumbling through tangles of excess administration. Congress should make some drastic changes, starting with allowing the government to negotiate better drug prices.

The president was correct, though, on the second point. Whatever the flaws of the program, it's all we have for now, and seniors should sign up.