By Kim Zamastil
Reporter

On November 15, some of America's senior citizens began registering for the new Medicare Prescription Drug Benefit, but many still do not understand what the benefit is or what they must do to receive it.

The new plan stands to greatly benefit seniors, especially low-income seniors, who carry the financial burden of paying for prescription drugs. But the complicated system creates a series of hurdles for the elderly.
Charles Llada, 73, though initially confused, has found the plan to be to his benefit.

"I understand it a little bit, and it's not as disappointing as I thought it would be," Llada said. "It covers about 90% of my medications."

The benefit relies on a variety of a prescription policies provided by private insurance companies. Each senior citizen who already qualifies for Medicare must research and choose the plan that best meets his or her needs. This is no small task; in New York State alone, seniors can choose between more than 60 separate plans, according "Medicare and You" a 100-page government booklet sent in October to every senior eligible for Medicare.

The booklets are part of a major education campaign launched by the Department of Health and Human Services. Working with government agencies, many private organizations throughout the country are sponsoring workshops to explain the new benefit.

Unfortunately, much of the explanation relies on complicated insurance terms and principles.

Perhaps the easiest way to find a fitting plan is through the Prescription Drug Plan Finder Tool on the Medicare Web site, www.medicare.gov, according to Dayle Burke, a health insurance specialist at the Centers for Medicare and Medicaid Services. The web site allows seniors to enter relevant information, then view and compare the plans that fit their needs. For seniors who are not Web-savvy, the same service is available through an operator at 1-800-MEDICARE.

A program called Extra Help assists those seniors who have an annual income and assets of less than $15,000 for a single person or $20,000 for a couple, according to an AARP guide to the program. Seniors with Medicaid or SSI automatically qualify. Those who receive Extra Help pay no monthly premium or deductible and no more than $5 co-pay for each prescription filled.

Seniors who receive Medicaid have been sent letters by the Social Security Administration telling them that they will be enrolled in a randomly-assigned plan if they do not sign up for a different one by December 31. The Medicare Rights Center lists 13 plans in New York for which Extra Help will pay the premium in full. Seniors randomly assigned to a plan, though protected, should still double-check that plan's formulary, or list of covered drugs, to make sure their prescriptions will be covered.

The system is far too complicated for most seniors to navigate on their own, as reported in nearly every major media outlet since the program's registration began. Anyone who knows an elderly family member, neighbor or friend should ask them if they have signed up for a plan, and if they have not, help them to do so. The longer someone waits to enroll, the more he will have to pay in penalties once he enrolls.

Once a plan has been selected, each senior needs to ask two important questions: Does this plan cover all of my prescriptions and dosages? Does my pharmacy accept this plan?

Seniors may sign up for the prescription benefit until May 15, 2006 without fear of late registration penalties. The benefit takes effect January 1, 2006.