Drug plan providers push to attract Medicare patients - 08/01/05

Article from the South Florida Sun-Sentinel Online
 
 
 

And so it begins, the race to lure patients into new Medicare drug plans, and the scramble to explain how senior citizens can take advantage of the benefits to help pay for medicine.

While Humana Inc. and Wal-Mart stores began reaching out to potential drug consumers in South Florida and around the nation, a network of 40 national organizations launched an education and advertising campaign Tuesday to encourage patients to enroll in drug plans starting in November.

"You can save hundreds of dollars a year," a narrator, wearing doctor's garb, tells viewers in nationwide television ads starting today. "But you have to sign up."

The education and ad campaigns coincide with widespread confusion and some skepticism about the prescription-drug benefits approved by Congress in 2003. The public mood has soured in part by drug prices, which continue to rise sharply along with other health-care costs.

"Thank goodness I'm not on many drugs," said Grace Krommes, a retiree from Delray Beach, who isn't sure the benefits will be worthwhile for her. "But you know, my day may come."

Krommes was headed for the vitamin section at a Wal-Mart in Delray Beach when she encountered a Humana display, the first of many consumer-education efforts to be sponsored by drug-plan providers.

Humana has set up shop in 500 Wal-Marts around the nation.

South Florida is a prime target for those who will be competing for drug consumers, with about 130,000 beneficiaries already enrolled in Humana's Medicare HMO.

Brochures bearing Humana and Wal-Mart logos were filled with general information about the new Medicare benefit.

Federal law does not allow providers to promote their plans until Oct. 1. But Cris Perry, sales director for the Palm Beach and Treasure Coast, said Humana wants to get out front because competition for enrollees is expected to be fierce. He thinks the education materials are a good way to start.

While Humana and other providers gear up for the enrollment period, a network of 40 groups -- including AARP and the National Association of Drug Chain Stores -- is banding together to help Uncle Sam promote and explain the drug benefits.

Its leader, former Sen. John Breaux, D-La., acknowledged that his own father was so confused by the new drug law that he called to say, "That prescription drug thing is not going to work, and I'm not going to worry about it."

Breaux said he knew then he had to help educate the public. "This is something the government cannot do by itself," he told reporters in Washington at the formal launching of the Medicare Rx Education Network.

The Network, while coordinating its efforts with the U.S. Centers for Medicare and Medicaid Services, hopes to deliver a consistent message to help consumers understand why and how they should enroll in the plans.

All Medicare beneficiaries are eligible. Enrollments begin Nov. 15, and patients must sign up by the end of this year to get coverage beginning in January.

Beneficiaries can shop among various plans to compare costs.

Backers of the new law hope this private-market competition, while initially confusing, will help rein in drug costs.

Most patients will pay a monthly premium, estimated at about $37, and a yearly deductible of about $250. They also will pay a share of drug costs, the provider will pay a share and Medicare will pay the rest, up to $2,250. Once total out-of-pocket drug costs reach $3,600, patients will pay 5 percent of remaining costs and Medicare will pay the rest.

The program is weighted to help low-income people. Individuals with annual incomes below $14,355 or couples with incomes below $19,245 may qualify for extra help.

The government says that by October, all patients will receive information from plans in their area.

"Seniors are used to getting a Medicare product from Medicare. This is a pretty big shift," said Tricia Neuman, vice president of the Kaiser Family Foundation, a healthcare policy organization. "[Drug plans] still come from Medicare, but they will have a lot of logos from different companies attached.

"There is a fine line between consumer education and marketing," she said. "Name recognition is going to be critical for these companies. But in the end, seniors need to focus on what's best for them."