Enrollment in the new Medicare prescription drug card program has begun.  Beneficiaries and advocates have many new questions to work through.  Accessible, accurate information is a must.  Proponents of the new law and the drug card program offer frequent assurances that this information is available to all, directing beneficiaries and those acting on their behalf to www.medicare.gov and 1(800) MEDICARE.  The Center for Medicare Advocacy works daily with beneficiaries trying to decipher the drug card program.  In the course of our work, many concerns have come to light that those seeking information on this program should consider.

The Official Medicare Website (www.medicare.gov)

• Many elders and people with disabilities do not have web access, and cannot easily leave home to use resources such as Senior Centers.

• Even if such resources are available, those staff available to help may not be familiar with the website or the information offered.

• The site is very complex.  One client who takes only three drugs was perplexed when she received 12 pages of information, then had to try to determine which plan would work with another program in which she participates.

• The site is in flux.  The Center was informed just this week that the complete list of drug card sponsors is not only not finalized, but will apparently be updated “regularly”.  One sponsor we were given was actually noted as “unable to market this plan at this time”.

• Information on the website may not be accurate.  For example, the site listed one Connecticut pharmacy that has been closed for several years.

• Information on the site may not match information being given out by other entities, such as state agencies.

• The prices listed on the site, when found, may not actually be the best prices for a beneficiary.  A member of our staff researched a list of drugs for three different zip codes in Connecticut and the Washington, DC area.  No cards were found that matched the low prices that were previously reported available by CMS.  The overwhelming majority of available cards did not offer prices better than those available at, for example, drugstore.com.

• Choosing cards based on name recognition may prove costly.  Beneficiaries might be tempted to choose a card with “a name they can trust”, but often these recognizable names offer more expensive options.

Medicare Hotline: 1 (800) MEDICARE  

• Clients report hold times too long to wait through.

• Several clients report that sometimes there is no ring-through at all.  In one instance a client got through, was put on hold for 8 minutes, then was disconnected.

• A client who did get through was actually told that those answering the phones were not trained adequately.

• Some clients report getting confusing or incorrect guidance on where to find the information they seek, or are simply referred back to the Medicare website, to which many have no access.

• In an informal Center for Medicare advocacy survey, Center employees phoned 1 (800) MEDICARE for some basic information for our clients (a complete list of the drug card sponsors), with disappointing results:
  

• 38% of calls were disconnected “due to unusually high call volume”.  With the amount of confusion surrounding these cards, it is unlikely that this volume will decrease significantly any time soon.  Callers were informed, however that access might be better before 6am or after 6pm – not convenient times for Medicare’s elder beneficiaries.

• 50% of calls were placed on hold, and callers stayed on hold for between 5 and 15 minutes.

• 12% of calls got through, after an average hold time of 11 minutes.  Operators were pleasant, but, unfortunately, not entirely helpful.  In one instance the caller was informed that the information was available on the website, but that was quickly followed by “well… I am not seeing that.”  This call was referred to the CMS reference center due to “the complexity of [the] question.”  The Center was told a response would be coming within three days of the call.

Beneficiaries and Advocates should be aware of the problems they will face in choosing, and enrolling in, prescription drug discount cards.  To minimize these problems, beneficiaries and their advocates should be prepared with current prescription information, including names, dosages, and current cost of the drugs being researched.  Know that not all drugs may be found, or discounted, and prioritize needs accordingly.  Most importantly, be prepared to be patient to get your information, and be willing to verify all information with other sources.

Do not rush making a choice.  The information from Medicare will, hopefully, get more complete and accurate in the weeks ahead.  Once a card is chosen, it generally cannot be changed until 2005.  This is not a decision to be entered into lightly.

© Copyright, Center for Medicare Advocacy, Inc. 01/08/2010