Events aim to clarify Medicare maze
Call him the Dr. Phil of Medicare.
Andrew Tartella, an outreach and education coordinator for the Centers for Medicare and Medicaid Services, gave a no-bull presentation on Part D, the new prescription drug benefit, to two dozen seniors in northeast Spokane Wednesday.
But don’t call it a “benefit” around him. That implies that you don’t have to pay for it.
“Is there anything free about Medicare?” he asked.
No, the audience answered.
Tartella is part of a team traveling through the Northwest on a bus wrapped in the Medicare logo. They’re helping seniors and disabled people – including about 60 at a meeting earlier Wednesday in Coeur d’Alene – sign up for drug coverage plans, which begin Jan. 1. After a presentation, they work with individuals on their options and try to cut through the confusion that some seniors say is as thick as week-old gravy.
“This is a real blessing to have this opportunity,” said Spokane resident Sharon Stillwell, 64, sitting next to Tartella at a computer after his talk. “I would have crawled over here.”
Stillwell had three pages of notes she had taken during multiple calls to 1-800-MEDICARE and to SHIBA, a mostly volunteer agency that gives free help on insurance issues. She has spine and joint problems that require her to take a muscle relaxer, among other drugs.
Stillwell qualifies for both Medicare and Medicaid, and the dual eligibility meant the government automatically enrolled her in one of more than 40 drug plans available. But there’s a problem. The plan assigned to her doesn’t cover Norflex, a brand-name drug she began taking after her body reacted poorly to its generic version.
“I don’t want to say I’m scared,” said Stillwell. “But the confusion. Maybe I have too much information.”
Tartella asked the group to relax and admitted that Part D is confusing.
“Show me an insurance program that isn’t,” he said.
He said seniors should ask themselves three questions when looking at each plan: Does it have the drugs I take? Does it have an agreement with the pharmacy I use? Can I afford it?
When one man asked why, after a May 15 deadline, monthly premiums will increase 1 percent each month, Tartella said simply that that’s how insurance works. Healthy people pay into a pool to cover the drug costs of the sick, and there has to be a cut-off date for the same reason you can’t sign up for home insurance while your house is burning.
“It (insurance) is a hedge against the ‘What if,’ ” he said.
He admitted there have been mishaps on Medicare’s Web site and on their telephone help line since Nov. 15, when people could begin choosing plans. The agency hired staff to operate the phones as part of the gear-up for Part D, and many of them “don’t have the background” to give good information, Tartella said. And then once the insurance companies, through which the plans are purchased, saw what their competitors were offering, they changed their prices and the drugs they covered to attract potential policyholders.
“It’s a tremendous concern for us,” he said.
After Tartella’s presentation, several seniors said they felt more comfortable with Part D. But there were still kinks.
“This may be our life’s work,” Tartella joked after an unsuccessful hour looking for a plan that covers the right muscle relaxer for Stillwell.
Although her condition cripples her neck and hands, a patient Stillwell seemed determined to work with Tartella until they found a solution.
“What I’ve got left is my voice,” she said.