Insurers market Medicare drug program
HARTFORD, Conn. — Insurance companies are advertising in senior citizen centers and pharmacies, using all forms of media, including 50-year-old images from “I Love Lucy” as they begin marketing the massive new Medicare prescription drug program.
Federal rules allowed insurance companies to begin marketing their products Oct. 1, and enrollment begins Nov. 15. The politically contentious drug plan, which was signed into law by President Bush in 2003, will cost nearly $400 billion over 10 years to implement.
But selling the most sweeping changes in the 40-year history of Medicare to a market of nearly 30 million seniors is not expected to be easy. One of four Medicare beneficiaries has some form of cognitive impairment that will require them to get help from adult children or other caregivers to choose among the various prescription plans, said Tricia Neuman, vice president of the Kaiser Family Foundation, an educational group.
They will have to choose from plans with numerous combinations of generic and brand drugs, each requiring different out-of-pocket costs and copays.
Medicare beneficiaries will be able to sign up for a stand-alone drug plan or join a health plan that offers drug coverage. Participating seniors will spend an average $792 for prescription drugs in 2006, excluding premiums, or 37 percent less than the $1,257 cost without the benefit, according to a July 2004 report by the Congressional Budget Office.
Gaps in the program pose problems for seniors who will participate. Costs will be covered up to $2,250, where the plan stops paying benefits until costs reach $5,100. The plan then resumes paying 95 percent of remaining costs.
Drug-store chain CVS Corp. on Monday announced partnerships with insurers Aetna Inc., Humana Inc. and the UnitedHealth Group in an effort to help seniors wade through those choices.
CVS is scheduling “Medicare Tuesdays,” inviting seniors and their adult children or caregivers to speak with pharmacy staff, said Jim Maritan, vice president for strategy and business development.
The pharmacy chain, based in Woonsocket, R.I., also is putting 37 million circulars in Sunday newspapers. And CVS has scheduled 100 meetings, with 400 more to come, at senior citizen and community centers.
A survey conducted by the Kaiser Family Foundation in August found that 29 percent of seniors said they did not understand the benefit at all and 31 percent said they did not understand it “too well.”
“To be fair, the educational effort is just ramping up,” Neuman said. “The debate has shifted from for and against the program to implementing it.” The program represents a major change for Medicare beneficiaries, she said.
“Up to this point in time, there were far fewer decisions and actions required. This really is a fundamental change in the program and the expectations for elderly and disabled people,” Neuman said.