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Drug plan faces enrollment challenge Original Source Link: (May no longer be active)    http://www.usatoday.com/news/health/2005-11-17-medicare-usat_x.htm http://www.usatoday.com/news/health/2005-11-17-medicare-usat_x.htm Posted 11/17/2005 10:47 PM Medicare drug plan faces enrollment challenge By Julie Appleby, USA TODAY FALLS CHURCH, Va. — Tom Downey and Sidney Shaw are examples of one challenge facing the new Medicare drug program: Neither man spends much on prescription drugs and they aren't sure the program will benefit them. Yet, if few Medicare beneficiaries like Shaw and Downey — relatively healthy seniors with low drug costs — sign up, premiums in future years could rise, possibly affecting the success of the program. But that group of seniors may be difficult to tap because some may pay more for the benefit than they currently spend on drugs. "I did some arithmetic, and it will cost me about $600 before I get a benefit from the program," says Downey, 69, of Alexandria. "But right now I don't spend $200 a year on drugs." Shaw and Downey were among more than 100 people who attended a forum Thursday explaining the benefit at a community center here. Enrollment in the drug benefit is optional. While many Medicare members are expected to save money by signing up, some will spend more. Beneficiaries have until May 15 to decide without facing a late-enrollment penalty. Shaw says he spends just under $500 a year on prescription drugs. He's angry that the new drug program is complex and more expensive than what he now pays. "I can go to drugstore.com and buy one of my drugs for 38 cents a pill, and under this plan, the drug would cost me $1.50 a pill," says Shaw, 69, of Falls Church. "If insurance companies have so much leverage to negotiate, why am I going to be charged more?" An analysis of what may happen to premiums in the Medicare plan by the Kaiser Family Foundation, a non-partisan research group, found: • If 80% of relatively healthy, higher-income seniors sign up, premiums would rise 11% in 2007, to an average of $38.08 a month.. • But if only 20% of those seniors join, premiums would jump 42% to $48.67 a month. Those changes illustrate a basic principle of health insurance: premiums from lower-cost, healthy members help subsidize the higher-cost policyholders, says economist Len Nichols of the New America Foundation, a health policy think tank in Washington, D.C. Nichols says seniors will likely weigh the pros and cons for a while before deciding on the drug benefit. "I don't think everyone was signed up by the third day when Medicare began in 1965 either," Nichols says. One of the challenges for the government is to promote the drug benefit to seniors and the disabled as insurance against future costs, not just a way of paying for drugs already being used, says Dan Mendelson, president of Avalere Health, a private Washington, D.C. —based research firm that conducted the study for the Kaiser foundation. "It's important that the administration help these seniors understand that this is insurance: You might be fine this year, but may need it next year," Mendelson says. Medicare spokesman Gary Karr says education efforts have focused on the value of insurance as well as the potential savings: "We've been trying to emphasize that this program protects people against higher drug costs in the future." Karr says Medicare has not prepared an estimate of premiums for 2007. This year's premiums average $34.33, the Kaiser study says. Gilbert Smith, 72, of Arlington, says he may join the program because it is insurance. He already has a Medicare supplemental policy that pays 50% of the cost of his drugs. But he's not convinced such supplemental policies will remain available, so he thinks he will sign up for the new Medicare benefit. "You just don't know what drugs you may need in the future," says Smith, who says he's looking at a plan with a $28 monthly premium. "For protection, $28 a month isn't that much," he says.

6 democratic candidates attack medicare measure { November 19 2003 } Aarp members burn cards Aarp spends 7m ad campaign supporting gop bill { November 19 2003 } Candidates take on aarp over drug bill Congressman bribed to pass medicare { November 27 2003 } Democrats threaten sue over medicare cost estimates Drug makers protect their turf { November 21 2003 } Drug plan faces enrollment challenge Drug prices for elderly climb 50 percent { July 1 2004 } FDA and states at odds over drugs { February 22 2004 } House probe medciare bribery allegation Medicare administrator withheld cost estimates for congress { September 8 2004 } Medicare costs kept secret Medicare drug benefit will cost more than reported { February 9 2005 } Medicare drug bill could be tough sell { November 17 2003 } Medicare drug cards produce confusion { July 29 2004 } Medicare drug cost estimate increases { January 30 2004 } Medicare reform bill is a disaser { November 28 2003 } Medicare secrecy inquiry is silenced { April 2 2004 } Medicare wont cover cancer drug costs { September 8 2004 } Medicares hidden bonanza { March 4 2004 } New drug benefits too complicated for seniors Nine dems back medicare bill Offered money to change vote { December 8 2003 } Some experts foresee revolt by elderly { November 26 2003 } Top democrats want us house probe on medicare vote US offers senior drug cards amid criticism { May 3 2004 } Files Listed: 27

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