Medicare updates Carson City residents on drug-plan changes
July 21, 2005
Medicare officials began a series of 40 visits to Nevada communities Wednesday to try and prepare Nevada seniors for the new Medicare prescription drug benefit.
Peter Bauer told more than 50 people at the Carson Senior Center the new drug benefit will begin Jan. 1 but that they will begin seeing advertisements for different health plans and drug benefit programs by October.
He told the seniors they will have to examine the different plans offered to pick one which best covers their needs but that Medicare and the state Division for Aging Services will be there to try help.
Bauer said Congress tried to design the plan so that it will expand the availability of prescription drug programs in rural Nevada rather than just concentrate on urban areas.
“If companies offer a plan, they have to have primary access statewide,” he said. “A plan cannot just service Las Vegas.”
He said that applies to PPOs and Prescription Drug Plans but that HMOs will still be able to offer their services in selected counties rather than statewide.
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“The new PPOs and drug plans must serve all of Nevada so they will have to make it available in Winnemucca and other small communities,” he said.
Bauer said he isn’t as concerned the drug benefit system will confuse and frustrate seniors as some. He said the way it works will be “very similar” to the way seniors now register for benefits through an HMO or other program.
“What they have to do is pick a plan to receive drug benefits much like they do now for other benefits,” he said.
He said both Medicare and the state will offer help identifying the different plans available in any given area – such as western Nevada – and some assistance in comparing those plans. But he predicted there will be several PPOs in Nevada along with drug programs offered by many different companies including supermarket chains and other large retailers.
Federal law sets minimum services the plan must offer but Bauer said those who can afford more will be able to get it through the different plans offered by health care and other businesses this fall.
“There will be premium plans but they’ll just cost more,” he said.
JoAnn Stewart, volunteer coordinator for the program with the state’s Aging Services Division, said the state is also trying to tie its Senior RX benefit program into the new federal Medicare program to provide better coverage. But, she pointed out, eligibility for Senior RX is tied to income.
Bauer said Medicare also recognizes some seniors don’t have the money to access the plan.
He said they can get help making the premiums and co-pay levels through Social Security.
He said Medicare and the state will spend the rest of the summer and into fall trying to reach as many Nevadans as possible to explain the prescription drug benefit – especially in rural Nevada. He said the goal is to hold meetings for seniors in a total of 40 communities throughout the state.
n Contact reporter Geoff Dornan at firstname.lastname@example.org or 687-8750.
Standard prescription drug coverage
Premium: About $37 a month
Expenses from $250-$2,250: Medicare pays 75 percent, recipient pays 25 percent.
Expenses from $2,250-$5,100: Recipient must pay 100 percent of costs.
After $5,100 total costs: Medicare pays approximately 95 percent of further expenses.
Call Medicare at 1-800-Medicare or The State Health Insurance Advisory Program at 1-800-307-4444 on weekdays.
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