Medicare Part D may not be the cure you were hoping to get | NevadaAppeal.com

Medicare Part D may not be the cure you were hoping to get

Ellen Nelson
For the Appeal

It’s often been said: “Be careful what you wish for, you just might get it.” The reality of that statement came to mind with the announcement that the Social Security Administration was adding prescription drug coverage to its Medicare program, effective Jan. 1, 2006.

As a retired senior citizen on Medicare, I had looked forward to signing up for Part D prescription drug coverage. I hoped it might be less expensive than my Nevada Public Employees’ Benefits Program and reduce my out-of-pocket costs. How wrong I was!

Why did I think the current administration, congress and their advisers could devise a plan that would truly be beneficial or easy to understand? Obviously, they had something else in mind than granting any kind of monetary relief to ordinary citizens. Part D seems directed more toward forcing us toward privatization of all health care coverage.

If you doubt this, it is spelled out on page 53 of the 2006 edition of “Medicare & You” which specifies on its cover: “Everyone needs to make a decision about prescription drug coverage.” Page 53 states:

Standard coverage (the minimum coverage drug plans must provide)

If you join, in 2006, for covered drug you will pay

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• A monthly premium (varies depending on the plan you choose, but estimated at about $37 in 2006)

• The first $250 per year for your prescriptions. This is called your “deductible.”

After you pay the $250 yearly deductible, here’s how the costs work:

• You pay 25 percent of your yearly drug costs from $250 to $2,250, and your plan pays the other 75 percent of these costs, then

• You pay 100 percent of your next $2,850 in drug costs, then

• You pay 5 percent of your drug costs (or a small co-payment) for the rest of the calendar year after you have spent $3,600 out-of-pocket. Your plan pays the rest.

In addition, there are certain enrollment requirements and deadlines. The first enrollment period began Nov. 15, 2005, for coverage beginning Jan. 1, 2006. Then you must enroll annually to maintain your coverage.

May 15, 2006 is the last day to sign up for 2006 coverage without paying a late enrollment penalty. According to “Medicare & You,” page 40, “Your premium cost will go up at least 1 percent per month for every month that you wait to join.” It also states, “You will have to pay this penalty as long as you have Medicare prescription drug coverage.” Under other circumstances, if you are late paying a bill one month, a penalty may be added for that month only, not the rest of your life.

Perhaps I’m missing something, but I fail to see how Medicare Plan D is better than or even matches my current prescription drug coverage under the PEBP plan, which I intend to keep.

Further, the out-of-pocket expenses required are an insult to those persons with fixed or limited incomes who have no prescription coverage. If they are struggling to decide whether to buy food or pay for doctor- prescribed medication now, where does a the federal government think they will find the money to pay a monthly premium of $37 or more, plus $250 deductible, plus 25 percent of drug costs up to $2,250, and then 100 percent of the next $2,850? But not to worry, if there are still months in the year (after they have spent $3,600 out-of-pocket) their Medicare authorized private insurance plan will pay the rest. Jan. 1 each year, the cycle begins again.

Is it possible our president, congress and other government officials in Washington, D.C, are so used to dealing with large monetary amounts in the millions, billions and more they cannot comprehend how many of our citizens are trying to get by on $5.15 an hour? As stated earlier, I am a retired state employee who has been working under Social Security since I was 13 years old. I am now 76, and to date, after being employed for more than 50 years, including all my earned income and current retirement benefits, I have yet to reach $1 million.

Finally, mindful that there is a movement to privatize Social Security, Lou Dobbs of CNN’s “Lou Dobbs Report” recently quoted from a letter found among the presidential papers of Republican President Dwight Eisenhower in which he wrote to his brother in 1954:

“Should any political party attempt to abolish Social Security, unemployment insurance and eliminate labor laws and farm programs, you would not hear of that party again in our political history. There is a tiny splinter group, of course, that believes you can do these things. Among them are H.L. Hunt, a few other Texas oil millionaires and an occasional politician or businessman from other areas. Their number is negligible, and they are stupid.”

Need I say more?

n Ellen Nelson is a Carson City resident and former employee of the Legislative Counsel Bureau