Deadline approaches for Medicare drug coverage

Wally Hinz, with his wife Karen, says he's the "master of procrastination." That's why he waited so long to sign up for Medicare Part D.
MPR Photo/Lorna Benson

Alida Purmalietis finds herself in high demand these days. That's because she knows more about Medicare Part D than most people. She's spent the past six months helping thousands of seniors evaluate dozens of drug plan options.

An educational group called "My Medicare Matters" trained Purmalietis on the finer points of Medicare Part D. Recently she met with Wally Hinz at the Vision Loss Resource Center in Minneapolis. She began by Hinz if he had his Medicare card and list of medications.

Comparing plans
Alida Purmalietis helps Wally Hinz sort through his prescription drug plan options.
MPR Photo/Lorna Benson

I have my Medicare card and I just have two medications. I didn't list them," said Hinz.

Hinz says he intended to sign up months ago. But time got away from him.

"I am the master of procrastination," says Hinz.

He's not alone. Sitting nearby are about half a dozen other seniors who are also asking questions. Several more wait outside the door.

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Hinz, who is blind, tells Purmalietis that he thinks he knows which plan is best for him. He just wants her to verify it. So she types Hinz's two medications into the Web site.

"As you had thought," says Purmalietis, "it's the Humana Standard plan that came up as the least expensive for you."

We have just heard a lot of apathy out there, that this is a lot of work for them to figure it out and they just don't want to deal with it.

The plan costs $1.87 a month and has a $250 dollar deductible. After Hinz spends through that deductible, Humana will pay 75 percent of his drug costs. But if his prescriptions exceed $2,250, Hinz has to pay the next $3,600 out of his own pocket. This is called a coverage gap.

Purmalietis tells Hinz that he probably won't spend enough to reach the gap. So he decides to enroll.

But then his wife Karen realizes they entered the wrong information.

"Alida, does it make a difference that he is cutting these pills? Can we talk about that?" she asks.

Purmalietis replies that it makes a big difference. She then revises his drug dose.

The Humana plan still comes out as the cheapest, which is all Hinz needs to hear. He decides to enroll.

"I think I might have figured it out," Hinz says, "but it certainly would have taken a lot more time, you know."

His wife Karen agrees. "And you may or may not have gotten the lowest cost."

Running out of time
Janine Stiles with the Minnesota Senior Federation says people are becoming more aware that they need to make a decision about Medicare Part D soon.
MPR Photo/Lorna Benson

To date, there are still about 231,000 Minnesotans who have no prescription drug coverage. It's possible that many, like Wally Hinz, are procrastinating.

But Janine Stiles with the Minnesota Senior Federation says some have deliberately held back.

"They were waiting to see how the program kind of shook out and to get the bugs worked out," says Stiles. "That's the biggest reason we heard."

Their concerns are valid. Last week Government Accountability Office investigators said that Medicare telephone operators routinely failed to give accurate information.

Investigators, posing as senior citizens, called the 1-800 Medicare line numerous times from mid-January through early February. They found that on very important questions, operators provided correct answers only 41 percent of the time. They also detected problems on the government's Web site and in handbooks.

Stiles says many of those issues have been sorted out. But she says the program is still too cumbersome for some folks.

"We have just heard a lot of apathy out there," says Stiles, "that this is a lot of work for them to figure it out and they just don't want to deal with it."

Stiles is worried that some seniors don't know they have to pay a penalty on future premiums if they miss the May 15 enrollment deadline. The penalty tacks on an extra 1 percent for each month they didn't take coverage when they were eligible.

Stiles' main goal before enrollment closes is to make sure that seniors get good information about Medicare Part D.

"Some people, it's not saving them anything. But we're also seeing some people where it's saving them substantial dollars. So you should at least check it out," says Stiles. Minnesota prescription drug enrollment was lagging behind many other states until recently. But Stile says the state's numbers have jumped significantly in the last month. That has moved Minnesota to about the middle of the pack nationally.