Social Services: Hold Off On

Prescription Plan Registration For Now

By John Voket

Newtown Social Services Case Manager Joanne Klopfenstein can talk to you for hours about the new Medicare Prescription Drug Plan, but you only need to see her rolling her eyes and shaking her head in disgust to get the message. On Tuesday, the first day that seniors could officially “sign up” for the plan, Ms Klopfenstein was fielding occasional phone calls and advising walk-ins at her Town Hall South office with the same message.

“Don’t sign yourself up for the program just yet!”

Newtown Social Services is among several local agencies and organizations that have hosted workshops and continue to serve as information resources providing website links and printed materials to help the hundreds of eligible Newtown residents to make the right decision when it comes to joining this new and what is being called “extremely complicated and confusing” program.

Newtown Senior Center staff members are also suggesting local seniors do not run out and enroll in these first few days of the plan eligibility period. The center is planning another information forum on the Medicare drug benefits with representatives from the Western Connecticut Area Agency on Aging (WCAAA) November 29.

That forum will detail specifics of the 44 different options available among the 17 plans being offered. It is those many options, and the specific implications of each, that has Newtown Social Services representatives calling for seniors to wait and see how the first few weeks of the process play out.

“We’re really trying to discourage seniors from rushing out until we have some more experience with the plan,” Ms Klopfenstein said. She said that even the basic information referenced in the original printing of the Medicare & You, book, which was circulated to millions of seniors across the country, was flawed.

“There were a lot of errors in that Medicare and You book,” Ms Klopfenstein said. “But instead of printing and mailing another book, or even a sheet [referencing the corrections], the administration decided to just put those corrections up on their website. How many seniors do you know that are going to be able to go on the Internet and find those corrections and apply them to the information in the printed book?”

Ms Klopfenstein bemoaned the plan’s administrators’ overreliance on the Internet for getting the basic information to a generation of Americans who are much more accustomed to reviewing and following instructions on printed materials. She also is taking the administrators to task for their websites that attempt to match individuals to the best plan for them.

“You go on these websites and you put in your information and it spits back anywhere from four to eight different plans that might be best for you,” she said. “But if you want specific details about any one of them, you have to cross reference individual user manuals for each. In the case of one of Aetna’s options, that manual is 44 pages long.

“Who’s going to be able to get through that?” she asked.

The Social Services case manager also noted that last week’s local public television round table on how specific Connecticut benefits work with the national plan may have caused even more confusion than clarification. She said answers to many of the questions posed to a panel of experts from local beneficiaries in the audience were laced with industry jargon and language that left more than a few audience members asking the same questions repeatedly.

“These kinds of programs just illustrate that there are two sides to this prescription plan; those administrators who understand some or all of it, and the many seniors who are at their mercy to depend on getting the best information for them individually,” she said.

In Connecticut, Ms Klopfenstein explained, the Medicare drug benefits dovetail with Medicaid plans and the state’s ConnPACE prescription benefit. And she said that anyone already receiving either of those benefits has until December 31 to choose the Medicare supplement desired, or one will be assigned that may not necessarily accommodate the prescriptions each person requires.

Most of the rest of those eligible for the national plan have until May 15, 2006, to sign up. A representative at the Newtown Senior Center suggested that individuals receiving veterans’ benefits, or those on Medigap or former employer plans should contact their primary providers for ideas and advice on which national program might work best.

“We are not suggesting that our seniors run right out and get signed up in these first few days,” said Senior Center Director Marilyn Place. “There is a worksheet available in our latest newsletter that seniors can use to get help from the Agency on Aging if they don’t want to try and do it on a computer themselves.”

The worksheet is available free for those who do not receive it by mail, and the center also has computer terminals if seniors want to independently explore online options, Ms Place said.

The national American Association of Retired Persons (AARP) organization is suggesting seniors across the country wait until more clarifications are made available to qualified candidates. The AARP website points out that if an individual’s annual income is less than $14,500 (as a single person) or $20,000 (as a married couple), they may be eligible for substantial extra help in paying for drugs and should call the Social Security Administration at 800-772-1213 as soon as possible to see if they qualify.

According to the AARP site, ConnPACE is available for low-income Connecticut residents 65 and older or the disabled. While Medicaid qualifiers are not eligible, those with an annual income under $20,800/individual, $28,100/couple are.

ConnPACE participants use a special discount card to obtain a 30-day supply or 120 capsules/tablets (whichever is greater) of most drugs at participating pharmacies. Participants pay $16.25 per prescription, and the additional cost to join is $30 per year

For more details or to apply, interested local residents may contact the state Department of Social Services at 800-423-5026 (in-state) or 860-832-9265 (out-of-state), or go to the program’s website www.connpace.com.

When it came to navigating any aspect of the worldwide web’s resources on the state or national programs, Ms Klopfenstein suggested that seniors who may be visiting with younger and more Internet-savvy children and grandchildren over the holidays may want to sit beside them at the computer and review some of the information, or at least take the opportunity to discuss the plan.

“After all, it’s being promoted by Medicare, but it’s being administrated by the drug companies so there’s bound to be confusion,” Ms Klopfenstein said, adding, “It’s a mess!”