Seventy-six-year-old Olin Crump studied the federal government’s new “Application for Help with Medicare Prescription Drug Plan Costs.” Then, he answered honestly:
He wouldn’t be able to fill it out alone.
“I don’t have much education,” Crump said apologetically.
Crump needn’t have been embarrassed. People with college degrees struggle with America’s indecipherable plan to help its older citizens pay for medicine.
Since the 2003 reform of Medicare, just 6 million seniors in an eligible pool of 17 million have gotten temporary discount drug cards worth up to $600 a year.
Some, like 68-year-old Shirley Williams, are bogged down in an impenetrable bureaucracy of income limits that most people don’t realize exist.
“I started applying last November,” she said. “My social worker is appealing.”
As the country moves from discount cards to permanent Medicare drug subsidies administered by dozens of private health maintenance organizations and prescription plans, the prognosis for confusion and underutilization gets worse.
Nowhere was that more apparent than at the Montbello Family Health Center on Thursday morning.
Mark McClellan, the physician who runs the federal Center for Medicare and Medicaid Services, flew from Washington to Denver to kick off a national campaign promoting permanent Medicare drug benefits, which begin Jan. 1.
U.S. Rep. Bob Beauprez of Arvada joined McClellan.
“We are a society that manages health with prescription drugs,” the congressman opined. “It would be crazy if we couldn’t provide a drug benefit.”
Sadly, he said nothing about benefits that makes sense.
On Thursday, McClellan pushed a program that lets Medicare pay virtually all drug bills for certain low-income seniors.
“When in doubt, fill it out,” McClellan proclaimed of the “Application for Help with Medicare Prescription Drug Plan Costs.” About 10 million seniors will qualify nationwide, he added, 100,000 of them in Colorado.
There were problems with his optimism. First, the application McClellan extolled contained the cryptic caveat, “This does not enroll you in the Medicare prescription drug program.” Seniors, it turns out, get nothing if they do not enroll in a separate process.
Second, when I called the Medicare drug benefit help number McClellan provided and followed 15 minutes of computerized cues, a polite, but apologetic Medicare representative told me she had “no information about drug plan enrollment.”
Old or young, Americans likely would find that confusing.
McClellan called it user-friendly.
Meanwhile, the elderly guests invited to McClellan’s appearance puzzled over a form that should have included a free morphine prescription.
Here is the text of Question 3 on the aptly named application for help:
“If you are single, a widow(er) or your spouse does not live with you, are your savings, investments and real estate (other than your home) worth more than $11,500? If you are married and living together, are they worth more than $23,000? (These limits will be higher after 2006.) Include the things you own by yourself, with your spouse or with someone else. Do not include your home, vehicles, burial plots or personal possessions. If you put an X in the YES box, you are not eligible for the extra help and you do not need to complete the rest of this application. You may still be eligible through your state Medicaid agency. However, if you want a decision, put an X in the NOT SURE box. If you put an X in either the NO or NOT SURE box, complete the rest of this application.”
This, said McClellan, is the best the government can do. The Social Security Administration is mailing 18 million copies to older, poorer Americans. Medicare, said McClellan, expects a better response rate than it got for the drug discount card.
If you’re over 65 and really want a way to pay for your prescriptions, bet the good doctor on that.
Jim Spencer’s column appears Monday, Wednesday and Friday. He can be reached at 303-820-1771 or jspencer@denverpost.com.