Medicare deadline is near

Medicare deadline is near
Candise Gregory understands the struggles that many South Dakotans, primarily senior citizens, must face as they try to make sense of the federal government's Medicare Part D program.

She worries, however, that many people eligible for the program's benefits will procrastinate, or put off making a decision because they hear from friends or neighbors that signing up is too much work.

It's Gregory's job to help people understand how Medicare Part D works, and what plan may best be suited for them.


She works for the Medicare Assistance Program office located in Sioux Falls, and was in Vermillion April 21 to conduct a "Medicare Fair" at the Senior Center.

Eligible people who don't sign up by May 15 will miss a golden opportunity, Gregory said.

"If they don't sign up in May, they're next opportunity to get in will be in November," she said. "And even if they look and enroll in November, their benefits won't begin until Jan. 1, 2007."

In contrast, benefits kick in June 1 for people who sign up just before the May 15 deadline.

This is the first time Medicare is paying for prescription drugs, an essential and expensive treatment for most seniors, and the largest expansion of the government health plan in more than 40 years. But persuading seniors to sign up has been an uphill battle, according to national news reports.

The deadline for signing up for the program is May 15. Nationally, more than 6 million eligible people reportedly haven't completed the paperwork yet.

Gregory, Kirsten Westra, Medicare educator with Senior Health Information and Insurance Education (SHIINE) of Sioux Falls, and Lucas Biefelt, of Medicare Today, an organization based in Iowa, met individually with several Vermillion residents.

Their time in Vermillion was fruitful; they met with 25 people who hadn't yet signed up for the Medicare program.

Nearly all were enrolled by mid-afternoon after selecting a plan and completing the necessary paperwork.

"What you have to realize is you can't look at 45 different booklets," Gregory said. "That's one of the reasons that it is confusing. How do you choose a plan from written material, and looking up what drugs you're taking and what the costs will be?"

Medicare staffers rely on a Web site to provide information as they help citizens. The electronic source of information helps them to custom tailor a plan that best fits consumers' needs.

"There is going to be a plan that is going to cover the majority of your medications, unless it's a drug that's not covered by Medicare's formula at all," Gregory said. "Sometimes it's really inexpensive premiums, sometimes it's a little higher, but still the savings that you receive on what you are paying currently for your medications and what you will pay with that plan are less. It's a savings."

Large numbers of people are baffled by the complexity of Medicare's drug benefit, which is being administered by dozens of private companies. They're weighing the costs of joining against the benefits, often without realizing that inaction could prove, in the long run, to be costly.

People who don't sign up by the May 15 deadline could end up paying a fine that totals 1 percent of an average drug plan's monthly premium.

"It takes about 30 minutes to go through the process, put all the data into the computer, and then present it to the person so they are comfortable with either making a decision right away, or taking the information with us to talk with their insurance agent or some other source," Gregory said.

Gregory was happy with the rather strong turnout at the Senior Center. But she would have been pleased if only one or two people would have been helped.

"Even if you have a low turnout, say of five people, it's five people that wouldn't have been helped if we wouldn't have gone to their community, and would have missed out on a great opportunity," she said.

"Sometimes one of those five people could be someone who ends up savings thousands of dollars," Biefelt said, "based on medications that are so expensive. If they would have had to pay that out of their own pocket, for somebody who is on a limited income, it's difficult."

Westra's and SHIINE's roles are to educate and provide general assistance to senior citizens about Medicare Part D.

"We might direct people about Medicare supplements and long-term insurance," she said. "The bulk of what I've done is outreach to promote the options under Medicare D."

Westra has been spreading the word about Medicare to anyone who will listen: veterans, Lions and Sertoma clubs, and even law students at USD.

There's a good reason to spread the word. There's a lot to learn.

"There are 41 plans with 17 companies and people need help to sort through all of that," Westra said. "We use the Web site program to work through that, and if a beneficiary decides to enroll, we can to it online."

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