By Susan Levine
Washington Post Staff Writer
Saturday, November 19, 2005
They came equipped with notepads of questions and lists of medications, and with the thick red-white-and-blue handbook "Medicare & You." Nearly 200 strong, they came looking for help in figuring out which among dozens of bewildering plans would buy them the most medicines for the least price.
Several hours later, many left a little less confused -- but not necessarily any closer to a decision.
"It's wearing me out," Betsy Curtin confessed as she and her husband departed the James Lee Community Center near Falls Church. She sounded almost indignant about the complexity of the new Medicare Part D Prescription Drug Coverage, the federal government's effort to offer millions of older Americans a way to better afford their pills.
"I'm a college graduate. I worked about 20 years for the Air Force," Curtin said. And she has a computer and some savvy using it. And still, papers in hand, she grimaced. "It's challenging."
Just days into the launch of Medicare's biggest expansion since its inception 40 years ago -- a program that could run taxpayers $720 billion in its first decade -- seniors and the people trying to advise them are incredulous about the multiplicity of options, deductibles, premiums and exceptions, which make comparisons seem overwhelming, if not impossible.
They say the same thing, whether in information sessions large and small or in one-on-one appointments. "It's been driving me crazy," said Rita Reitman Sobel of Alexandria, her face betraying her doubt and anxiety after Thursday's presentation.
What she and the rest of the audience heard was hardly reassuring. Although Part D will greatly benefit certain people, its savings are not universal. The annual costs of its various plans, which are being marketed by private companies, can vary by thousands of dollars, and a penalty could multiply many beneficiaries' bills by thousands more if they sign up after the deadline.
And the best way to sort out the competing information? Via the Internet -- and searches that most seniors say are beyond their ken.
In Virginia, they are faced with nearly four dozen plans. The number exceeds 50 in Maryland and climbs to 67 in the District. Enrollment started Tuesday and continues, for those 65 and older, until May 15. Actual coverage begins Jan. 1.
The program's arcane intricacies and implementation, preceded by a barrage of advertising, have been so criticized that some lawmakers are pushing for a two-year delay.
"This is a bad piece of legislation, and it never should have been enacted," Rep. James P. Moran Jr. (D-Va.) told the community center crowd, which responded with applause.
The program is too complicated, he said, too expensive and "too much of a giveaway to the pharmaceutical companies."
Yet, Moran added, "I want to emphasize, I don't think you have a choice. You've got to sign up for it."
Questions and concerns took on greater urgency after enrollment officially commenced this week. Calls to the Medicare Rights Center, an independent, New York-based organization, quadrupled over previous weeks' volume.
"People know the marketing materials arrived in the mail . . . that there's a benefit, but whether it's right for them is a complete mystery to them," spokeswoman Deane Beebe said yesterday afternoon. "We're still trying to figure out what to tell them."
The Fairfax Area Agency on Aging has trained volunteers to assist local residents who walk through the door, sometimes carrying a shoebox of pill bottles. The seniors listen carefully but, invariably toward the end of the conversation, lean in close and lower their voices.
"They say, 'What would you do?' " program coordinator Howard Houghton said. When the counselors explain that they can't cross that line, their clients try a different approach: " 'What would you tell your mother to do?' "
The luckiest seniors -- among them, retired federal employees and veterans -- need not worry any because they already have coverage equal to or better than the new plans. Even if that coverage changes or ends and they move to Medicare, they will not risk the uncapped penalty of 1 percent a month for their delay.
For others, it will come to this: worrying for much of the next six months over what to choose.
"I shudder when I think of all of it," Gloria Nagan admitted after listening in on a Thursday evening presentation at The Irene, a high-rise in Friendship Heights. She took away a 12-columned spreadsheet laying out the broad particulars of the plans available in Maryland.
"How do you pick?" she asked.
Around computers in an Alexandria apartment complex's community center, several seniors paired yesterday with workers from the city's Office of Aging and Adult Services and tried to make sense of the future.
Social worker Irene Ilachinski sat with Maria Tarzi and looked over her list of medicines. "I don't know if there's a plan that takes all of them," she said, "but we'll see what's available at least."
Ilachinski called up the online Medicare Prescription Drug Plan Finder and began clicking on specific brand names: Zocor, Plavix, Nexium and a half-dozen more. Thirty-five plans popped up.
A few feet away, MaryAnn Griffin typed in the same details and appropriate dosages for Tarzi's cousin, Mahboub Rafik, and then hit enter. The results: 40 possibilities, from a Humana plan with annual costs of $3,880.66 to a plan from PacifiCare that might run $10,257.12 a year.
"Well," Griffin said to Rafik, "we're not going to take that one, are we?"