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News >  Idaho

Program set to tackle drug benefit paperwork

Thousands of North Idaho seniors and disabled people received envelopes in the mail this week that could save them hundreds of dollars every year if they just have the patience to decipher the contents.

The letters are from the Social Security Administration, and they contain six pages of questions that most likely will prompt many recipients to drop them in the trash, said Mary Dusek, a training coordinator with the state Department of Insurance’s Senior Health Insurance Benefits Assistance (SHIBA) program in Coeur d’Alene.

The questionnaires are part of the prescription drug benefit that Medicare will start offering next year. Medicare recipients living at or below poverty level won’t have to pay an annual $250 deductible or a monthly premium for the benefit. Their answers on the questionnaire will determine whether they qualify for the help.

“The questionnaires will be rough for some people to fill out, but we’ll help them,” Dusek said.

About 50,000 residents in Idaho’s 10 northern counties are on Medicare. Most are older than 65 but many are younger and disabled. Dusek is certain all are confused at Medicare’s new program. SHIBA has taken on the responsibility of answering all the questions and signing people up.

Only people considered low-income are receiving questionnaires now, she said. The 16 questions seek financial information about bank accounts, stocks and bonds, cash at home and more. SHIBA is seeking volunteers now to train to help people with the questionnaires and with enrollment in the prescription benefit program in the fall.

The questionnaire is worth the time, Dusek said. People certified as living at the poverty level – $12,569 a year – will pay $1 to $3 per prescription in the program, and nothing else. People living below 135 percent of the poverty level will pay $3 to $5 per prescription, and nothing else. But the benefit doesn’t kick in until the Medicare recipient has paid – through benefits or out of pocket – $5,100 for medications.

People not considered low-income have until November to decide whether to enroll in the program. Pearl Bouchard, director of Aging and Adult Services in Coeur d’Alene, said 23,000 seniors in the five northern counties are eligible for the prescription benefit. But she believes many won’t enroll.

“They don’t need it now, and if they apply, they have to pay a premium,” she said. “But if they don’t sign up now and need it later, there’s a penalty.”

It’s a gamble, Dusek agreed. Medicare recipients who don’t sign up this year because they don’t need the benefit will pay an additional 1 percent per month when and if they do sign up. The penalty is permanent. If they do sign up this fall, they’ll pay $37 a month even if they don’t use it.

“It’s like insurance,” Dusek said.

The number of plans Medicare will offer will complicate everything. Seventeen pharmaceutical companies have applied to offer plans in Idaho, Dusek said. All the plans have different prescription benefits.

“People will have to decide which plan is best for them,” she said.

SHIBA and Aging and Adult Services are working together to offer public workshops on the Medicare prescription program. SHIBA also is seeking volunteers willing to train in the program and help people with questions about enrollment.

Dusek is advising people not to throw any paperwork away in frustration because Medicare will accept only original forms, no copies. SHIBA has originals of the low-income questionnaires.

“It’s a big undertaking, but it will benefit a lot of people,” Dusek said. “I’ve had people cry on the phone because they have so many medications and don’t have the money. We don’t charge for services. People can call us for assistance.”

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