Not Worth The Trouble? New Medicare Drug Discount Cards Are Breeding Confusion Early On

Far from clarifying essential health issues, the new Medicare prescription law and its discount drug card have left seniors and disabled people perplexed about their benefits. 

“Beneficiaries are badly confused at this early stage about this law, and that means that it will take a major effort to educate and inform if the law is to be successful and if seniors and disabled people are to make the best choices for themselves and for their families,” Drew Altman, president and CEO of the Kaiser Family Foundation, said Thursday at a teleconference.

Altman was presenting the results of research that found seniors and the disabled were confused by the new cards and not pleased with the new law.

The law took effect on June 1, when seniors and the disabled became eligible to sign up for the prescription drug discount cards, which will be used until Medicare offers prescription insurance in 2006.

But, according to a report in Newsday, the number of seniors who actually have signed up is minimal.

According to Democrats opposed to the Bush administration-supported plan, the newspaper said, only 500,000 out of 2.8 million Medicare enrollees voluntary signed up for the new cards. The rest were automatically enrolled. Health and Human Services Secretary Tommy Thompson said the lag was due to “window shopping.”

Varied Concerns

For its survey, Kaiser commissioned 10 focus groups in several locations around the U.S. The participants were divided into household income groups: of less than $17,000 yearly; $17,000 to $35,000 yearly; and above $35,000 a year.

The panelists were asked how they felt about the Medicare system in general, how they felt about the new law, and about specific aspects of the new law.

Both seniors and people with disabilities registered negative feelings toward the new drug benefit even as they expressed positive feelings about Medicare in general.
On a scale of 0 to 100, with 100 being the most favorable, seniors rated their perceptions of the new drug benefit at 31.

“The fact that the system is confusing is one of the reasons people give it a negative score,” said Geoff Garin, a partner with Peter D. Hart Research Associates, which conducted part of the research. “There is a view they’ve created a Rube Goldberg contraption.”

Survey participants were asked to review the following hallmarks of the discount cards:
• They are offered by private companies such as pharmacies, health insurance companies, managed care plans, and others in 2004 and 2005;
• They allow people on Medicare the option of choosing the card that best meets their needs based on the prescriptions they take;
• They have an annual enrollment fee of up to $30 for most people, but those with lower incomes do not pay the annual fee;
• They are estimated to provide savings of 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 25{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} on prescription drugs, and while savings could be higher, minimum discounts are not guaranteed;
• They provide lower-income people on Medicare with incomes of less than $12,569 for singles and $16,862 for couples with a $600 credit on their Medicare drug discount card in 2004 and again in 2005 to help pay for prescriptions; and
• They will be offered only in 2004 and 2005 and will no longer be offered once the Medicare prescription drug benefit starts in 2006.

After considering these features, 14 of 65 panelists said they felt favorably toward the discount drug cards, 14 had no strong opinion, and 37 had an unfavorable opinion.

Concerns about the drug discount cards centered on five areas. First, many panelists felt that the 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 25{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} discounts are not substantial enough to make the drugs affordable. Beneficiaries also point to the fact that the discounts are not guaranteed, which significantly raises their level of skepticism about the cards.

“It’s confusing,” said one younger beneficiary with disabilities. “And then it’s not enough. I mean, you can go on the Internet and get your drugs from Canada at 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of what you buy them here.”

Seniors and beneficiaries with disabilities convey significant apprehension about investigating and choosing from a large amount of cards. One concern is a belief that many seniors will have difficulty making good decisions about which cards are best for them. This confusion is well illustrated by one survey participant’s comments.

“I have heard that, depending on your circumstances, different people will be issued different-colored cards,” she said. “These different-colored cards are supposed to tell you what your benefits are and how much you’re going to get for your prescriptions, and so on and so forth. I mean, how is one going to determine who gets what color card? And if the circumstances of a person change, what do they have to do to get a different colored card to get more benefits? I mean, it’s really confusing.”

Seniors also wonder what prescriptions will be covered by each card, and whether they will have to purchase more than one plan. A parallel concern relates to the fact that the cards would be discontinued after two years, which would force them to learn a new system after already having educated themselves about the interim plan and the many cards offered.

On the positive side, some feel that the cards would offer considerable assistance to poor beneficiaries. This was the opinion of one woman in the survey, who said, “for those lower-income people, it certainly works to their advantage.”

Layers of Confusion

Seniors also tended to confuse the discount cards with actual drug coverage.

“People are much more resentful than they are grateful,” Garin said. “There’s a feeling that no one has done them a great favor.”

On the other hand, panelists tended to believe the law could help people with low incomes. “It is seen as genuinely beneficial for low-income people,” Garin said. One group that responded favorably was those with lower income, “but they are very intimidated about navigating,” he said. “So the group that most stands to be helped by the law, in some ways, feels most at sea in accessing the law and being able to use it.”

Disabled beneficiaries expressed generally the same concerns as seniors, although perhaps more vociferously.

“The one thing that we heard consistently is that people simply do not have this benefit figured out,” Garin said. “Seniors come to this with very little understanding of how to navigate the system that has been created for them.”

This article was obtained from HealthDay News and the Kaiser Family Foundation.

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