Few Options for Medicare Part D Drug Benefit

Although several details of the new Medicare Part D drug benefit plan are yet to be set, seniors who don’t enroll for the prescription drug coverage will be penalized 12 percent for each year they delay in signing up for the program. Some seniors wouldn’t need to enroll in the program because they have no current drug bills or small drug bills at least. They will have to enroll to save themselves what amounts to a penalty though.


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“I just feel this penalty is blackmail and undue pressure,” said Beatrice Lumpkin, an 87-year-old Medicare recipient living in Chicago speaking with the Chicago Tribune.

The Bush administration and Congress have stressed the need for all Medicare-eligible seniors to sign up for the program to ensure its success. Cost control is the aim of the program that could cover over 20 million seniors although estimates vary. The plan is expected to provide $1,300 in average coverage.

The projected monthly fee is $37 or $444 yearly but for those passing up the initial open enrollment period of November 15, 2005 to May 15, 2006, and waiting a year to sign up for the benefit would have to pay over $41 monthly or over $497 yearly in the second year. If a senior waited until the third year to enroll, they would be paying over $46 monthly or almost $557 yearly to enroll. The yearly cost would be over $623 in the fourth year.

“Once the cost of those premiums begins to go up, it is going up dramatically, said Terri Gendel speaking with the Chicago Tribune. “Down the road it could price them out of a plan, depending on how much the prices go up,” Gendel added. She is the director of benefits and advocacy for the Suburban Area Agency on Aging based in Oak Park, Illinois.

After signing up for the Medicare Part D drug plan, those seniors would receive a drug card from a pharmacy benefit firm or health insurance plan. These private firms will contract with Medicare to provide these services. Benefits are scheduled to begin January 1, 2006.

“What if a healthy senior who is on no medications and is 65 says: What the hell? I am not going to pay $37 for a prescription card when I don’t take any drugs,” said Sydney Bild, an 83-year-old Medicare recipient living in Chicago speaking with the Chicago Tribune. “Come three years later and they develop hypertension or diabetes, they are going to be penalized and pay more. This doesn’t seem to be fair.”

Details regarding information such as any out-of-pocket expenses or what drugs will be covered will not be known until the firms start signing contracts with the Medicare program in September. Out-of-pocket expenses like co-payments and deductibles will surely differ from company to company. These details will be available publicly in October, when the contracted companies will be allowed to start marketing their programs.

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