Drug benefit aims for poor

WASHINGTON – One year after foul-ups spoiled the launch of the Medicare prescription drug discount card, the government is hoping for a smoother rollout of a new benefit that will essentially provide free prescription drugs for millions of the poorest Americans.

On May 27, the government will begin mailing letters to nearly 20 million elderly citizens asking them to fill out a five-page application for the new Medicare benefit. On May 31, more letters will alert another 10 million people that they will automatically qualify for the coverage, which will pay between 85 and 98 percent of drug costs beginning 2006.

The enhanced coverage is one of the most generous public health offerings in U.S. history. It will provide immediate relief and life-prolonging treatments for millions of impoverished people struggling with high prescription drug costs.

Yet getting the benefit requires an extensive application as well as an income and savings test to ensure that the poorest Americans qualify.

Medicare officials estimate that 1 in 3 of their 43 million beneficiaries will be eligible – roughly 14.4 million people. But the actual number could be far higher – as the mailing of 20 million application letters suggests.

While the early application period should help Medicare sign up more people, some experts say it may not be enough to avoid the confusion that greeted the launch of the Medicare-approved discount drug card program.

Of particular concern is the five-month gap between applying for the drug benefit in June and selecting a drug plan in November. That lag could cause many people to forget the November enrollment requirement.

The five-page application, which requires information about bank accounts, insurance policies, stocks and other personal assets, could prove daunting. Twenty-three percent of Medicare beneficiaries have cognitive impairments, 29 percent live alone and 29 percent are in fair or poor health.

Similar problems forced Medicare to hire hundreds of new phone operators last year to handle millions of calls from people confused and frustrated by the application forms and enrollment process for the discount cards.

The card program, which will be replaced by the discount drug benefit in 2006, was slow to recover and hasn’t met original enrollment expectations. Only 25 percent of eligible low-income Medicare patients have signed up for cards even though the cards pay $600 a year toward their drug costs.

If the application drive for the low-income benefit is successful, it will portend a smooth transition into the full Medicare drug benefit. But if needy seniors stay true to history and don’t sign up in high numbers, the valuable coverage could miss many of the people who need it most.