State offers drug plan assistance

The State Department of Human Services is offering help to those who have questions about the new federal Medicare Part D prescription-drug-benefits program.

Those who have questions about this federal program, which kicked off Sunday, or need assistance in choosing a plan may call toll-free the following numbers:

  • The Centers for Medicare and Medicaid Services, 1-800-MEDICARE (1-800-633-4227);
  • Sage PLUS, 1-888-875-2229.

The DHS has also set up a Kaua’i hotline number, 245-7580, at the Kaua’i Legal Aid Society of Hawaii (LASH) office to provide additional assistance for Medicaid clients on an ongoing basis.

People calling LASH must meet the income requirements of 125 percent of the federal poverty level — $1,147 a month for a single person).

DHS has also launched a new State Pharmacy Assistance Program (SPAP) to help low-income seniors and disabled individuals pay the co-payments for their prescription drugs under the Medicare Part D program.

That number is reachable toll-free from Kaua’i: 1-866-878-9769.

According to a 2003 survey of Hawai’i residents conducted for members of the American Association of Retired Persons, half the population, particularly those ages 50 and older and those with lower income, is concerned about the rising cost of prescription drugs.

Depending on individual financial circumstances, relief may be on the way, or already have arrived, with the start of the new Medicare prescription-drug coverage, according to an AARP press release.

A free AARP publication can help Hawai’i residents make important decisions regarding their drugplan options, the spokesperson said.

“Prescription drug costs continue to outpace inflation, making affordability tougher for many Hawai’i residents,” said Barbara Kim Stanton, AARP Hawai’i state director.

“Through our new publication, information in the AARP Magazine and the Bulletin, on the AARP Web site and through community and national partnerships, AARP is helping our members, their families and caregivers better understand their new coverage options,” she said.

The new drug plans work like private insurance, but Medicare picks up most of the cost, Stanton explained.

Most who enroll will be responsible for monthly premiums, co-payments and deductibles. Limited-income beneficiaries will receive either free or very-low-cost coverage.

The drug coverage is voluntary, with enrollment on now through May 15. Those who don’t enroll by May 15 may be subject to a late-enrollment penalty if electing coverage in the future, she explained.

AARP’s free publication, “The New Medicare Prescription Drug Coverage: What You Need to Know,” is available by contacting AARP toll-free at 1-888-687-2277, or by visiting the Web site, www.aarp.org/medicarerx.

There are a number of plans now available as a result of the new Medicare Part D prescription-drug plan, and at least one other expert recommends seniors focus on the specific options that apply to them in order to simplify the process and reduce the risk of selecting the wrong plan for their situation.

Melissa Gannon, vice president of Weiss Ratings, Inc., a company that evaluates the strength of medical-service providers, said to streamline the process and give seniors confidence to select the plan most suitable to meet their needs, her company offers a free Medicare Prescription Drug Planner.

It outlines options available, instructions for calculating and comparing annual plan costs, and steps seniors should take to choose the plan that best fits their lifestyle, including:

  • Review current coverage. The goal is to have a complete health-benefit package, including prescription-drug coverage. Before doing anything, understand what plan or plans you currently have and what it costs you, including any costs associated with a supplemental plan;
  • Find the cost of a Medicare Part D plan. After gathering critical information about your current coverage and prescribed medications, use the Medicare Web site to identify and select and appropriate drug plan;
  • Evaluate five to seven Part D plans. With the number of plans averaging 40 per state, it is overwhelming to evaluate every one. Limit the number of plans you compare to a manageable amount, and add new ones only if none meet your requirements. In addition to premium cost, remember to consider other out-of-pocket costs, completeness of coverage, and accessibility;
  • Consider a Medicare advantage plan. These plans offer one package for a single premium, so they are worth considering. Be sure to review all the benefits, including prescription-drug coverage and provider accessibility, before making a choice;
  • Assess the benefits of a Medicare (Medigap) supplement policy. Medicare Part D alone does not replace benefits from a Medicare (Medigap) supplement policy, therefore, part of your cost comparison should include the price of a Medigap policy. These policies include benefits that supplement other Medicare coverage beside Part D. Medigap prices can vary dramatically even within the same city, so research this carefully;
  • Complete the Medicare Prescription Drug Planner worksheet. Use the planner’s easy-to-use worksheet to review and compare the annual cost of prescription-drug coverage options;
  • Seek more information. If you need more information about the Medicare prescription-drug benefit, take advantage of many valuable resources, including www.medicare.gov.

The Medicare Prescription Drug Planner can be downloaded at no charge at www.WeissRatings.com/PDDPLAN_intro.asp.

For more information about the Medicare Prescription Drug Planner or Weiss, please see the Web site, www.weissratings.com, or call toll-free 1-800-289-9222.

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