African-Americans and the Medicare Drug Plan: Too Many Choices Better Than No Choice At All?

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If it’s true that it’s the American way to work hard for anything that’s worthwhile, older Black Americans should dust off their reading glasses and prepare to tackle the intricacies of the new Medicare Prescription Drug benefit. Medicaid drug coverage ends for 6.5 million people who have been dually covered by Medicare and Medicaid in December 2005. It’s anticipated that 30 million Americans will join a new Medicare drug plan by January 2006.

Many observers feel that the volume of choices offered by the plan leaves people overwhelmed and confused. This is a valid concern since in most states, Black consumers will have to select from among as many as 40 different plans. And while the discounts on maintenance and life–saving prescription drugs are not massive, the program will offer serious costs savings over time and some plans even provide protection against future catastrophic drug costs. This is critically important for the four million African–American consumers who currently receive Medicare, many of whom live on fixed incomes well below the poverty level and are in ill health.

The new drug plan is cumbersome, but not impossible to decipher. Here are two baseline facts of special importance to African–Americans:

  1. To receive discounts on prescription drugs you must enroll in one of two plans – Prescription drug plans (PDP) and Traditional, fee for service Medicare OR Medicare HMO’s or PPO’s for prescription drugs and basic benefits.
  2. For people with low incomes, premiums and cost sharing assistance is available.

Following are important considerations to keep in mind while trying to decide which plan best fits your needs. Ask yourself:

  • Which type of Medicare plan do I want?
  • Which plans will cover the drugs I take now?
  • Is it more important to me to get discounts on all my drugs or just the drugs that are most expensive?
  • How much will I pay for each prescription?
  • Are the pharmacies I use in the plan’s network of participating pharmacies?
  • Two thirds of African–Americans receiving Medicare are eligible for subsidized help to participate in the Plan. Are you one?

If you think the answer might be "yes" to the last bullet point, you may be eligible if you are an older person of low income (less than $15,000 a year for an individual or $20,000 for couples) or if you are under age 65 and currently receive disability benefits. Either way, you may have to apply for subsidized help through Social Security or Medicaid – by mail, phone or online.

If you feel overwhelmed trying to understand the plan, don’t despair, get help. Ask a friend, relative or one of your adult children to assist in deciding what prescription plan is best for you. Medicare has tried to demystify the ins and outs of the program on their website and in a series of free brochures. The American Association of Retired persons (AARP) has also done a good job laying out essential features of the plan.

Consumers are encouraged to sign up for a plan of their choice by January 1, 2006 to ensure no gap in coverage for prescription drugs. There’s a grace period for late sign–ups until May 15, 2006. After that the premium on whatever plan you choose could increase by 1% for each month you delay. Even if you are currently not taking any prescription drugs, it’s a good idea to join one of the lower premium plans by May 15 to shield yourself against future prescription drug needs should they occur and avoid a late enrollment penalty.

African–American elders have conquered greater challenges than comprehending the details of Medicare’s prescription drug plan.

Hang in there and take advantage of the real savings you’ll realize in the months and years to come.

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