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Confusion costs seniors money

If, like Will Rogers, you only know what you read in the papers, you might think the Medicare Prescription Drug, Improvement and Modernization Act passed by Congress last year was a seriously flawed and failed piece of legislation.

It’s true that seniors haven’t been given enough credible information to make sound decisions about their health care, and the resulting confusion surrounding the most sweeping reforms in the Medicare program’s nearly 40-year history have prompted skepticism among seniors nationwide. Unfortunately, that skepticism is proving to be costly, causing many seniors to take a “wait-and-see” approach.

For millions of America’s seniors – including those in Nevada County – the old saying “time is money” rings true, and there are many reasons to believe that many seniors may be “leaving their money on the table.”



A new study by the Lewin Group, an economic analysis firm specializing in health and human services research, found that seniors using the new Medicare Drug Discount Cards offered by the new legislation may save, on average, more than $1,200 through 2004 and 2005.

The study analyzed 150 drugs most frequently used by seniors and found that as many as a quarter of the discount cards offer savings of more than $700 (nearly 20 percent) off retail costs over 18 months, and more than half of the cards offer savings of over $600. In addition, Medicare beneficiaries will have saved up to $7.7 billion on their prescription purchases by the end of 2004 if Medicare Drug Discount Card enrollment continues to grow as projected by federal government.




Once the election-year rhetoric subsides and they can see Medicare reform for what it is, seniors will find that this historic legislation is already making an immediate and positive impact by expanding the role the private sector plays in offering seniors more affordable, comprehensive health care coverage options. For seniors enrolled in Medicare Advantage (also known as Medicare+Choice) plans, these changes have been significant.

Thanks to the increased funding provided by the legislation to better support the private sector, Medicare Advantage plans are offering their members – in addition to affordable prescription drug coverage, something many of them have offered for years – enhanced benefits and reduced premiums and copayments beyond what is currently available through original, “fee-for-service” Medicare.

Many of them are offering new, innovative health care products and services such as “disease management” programs for chronic, medical conditions that commonly afflict the elderly, such as congestive heart failure and cancer. Currently, disease management programs are available only to a small number of Medicare fee-for-service enrollees under demonstration initiatives.

In addition, Medicare Advantage plans are expanding into new service areas, including rural areas, which will see for the first time affordable health care options for senior residents.

Since private-sector health plans began participating in the Medicare program more than 20 years ago, they have helped keep out-of-pocket costs lower for beneficiaries. A Rand study published last year found that Medicare health plans, when compared with fee-for-service Medicare, reduced out-of-pocket costs by more than $800 annually for the average beneficiary and by $2,160 annually for beneficiaries with the highest health care costs.

That’s a lot of money to leave on the table.

ooo

Kathy Feeny is executive vice president Secure Horizons Senior Solutions.


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