Counselors try to allay the concern and confusion of people eligible for a new federal program to provide affordable prescription drug coverage.

09:10 AM EST on Wednesday, November 16, 2005

BY JENNIFER LEVITZ
Journal Staff Writer

WARWICK -- Hundreds of elderly people rushed to the Warwick Mall yesterday for counseling on the federal government's complex new prescription drug plan on the first day of enrollment.

"A-52!" an announcer called.

"Bingo!" someone shouted back.

That was the weary humor that took over "Medicare at the Mall," an event held to help elderly and disabled people enroll in "Medicare Part D," a program that could benefit many, but whose design makes a day at the Registry of Motor Vehicles look like a picnic.

Journal photo / Mary Murphy

Shanon McKay, left, a pharmacy outreach program volunteer, talks to Henry Stad, center, of East Providence, and his brother, Walter Stadnicki, of Pawtucket, about a voluntary prescription program, Medicare Part D, yesterday at the Warwick Mall.

"Either I have totally lost all my neurons or this program is a mess," sighed Jonita Rives, 83, a retired social worker who lives in Warwick.

She shook her silvery bob and leaned in and smirked like she had a juicy secret: "Whoever said growing old was fun, he was on some serious drugs."

Few actually enrolled yesterday at the event, which was sponsored by the Medicare RxAccess Network of Rhode Island and the Rhode Island Department of Elderly Affairs. But by noon, 255 people had taken a number to privately see a counselor in one of the green-curtained booths set up near Kay Jewelers, under an American flag. Enrollment ends May 15, 2006.

Medicare Part D is the biggest change to Medicare in the program's 40-year history. In traditional Medicare health insurance, people who are 65 or disabled go to a doctor, who bills Medicare.

But Medicare Part D is wildly different. The government has contracted with private insurance companies to offer affordable prescription drug coverage. In Rhode Island, the elderly must choose from 18 competing insurance companies who are offering dozens of plans. Not all plans cover all drugs.

Some people, including Rives, left counseling yesterday feeling better. She had narrowed her choices down to a few plans, and believed she could save a lot of money on prescription drugs.

But others felt that they were seeing government bureaucracy at its worst.

"This is the worst confusion I've seen in all the years I've lived and I'm 91," snapped Lawrence DiChiaro, tugging at his green baseball cap. "That's why they can't win the war. They don't know what they're doing."

The plan, which Republicans hope will be one of President Bush's greatest achievements, is a true insurance program so it will only work if enough people enroll. And the participants can't all be sick. The program needs to enroll healthy people to keep costs down. Yesterday's event was part pep rally and sales pitch for Medicare Part D.

State and Medicare officials took the podium, emblazoned with the Warwick Mall logo, saying they would implore their own parents to enroll.

Attendees, mostly elderly people, were gamely reminded that they might be relatively healthy now -- but in a month or two or three, who knows?

And the seniors were warned of seemingly eternal consequences for opting out.

Medicare Part D is voluntary. But if Medicare beneficiaries don't sign up during this enrollment period, but sign up later -- the insurance companies can charge a higher premium.

"You can be penalized for life and that's something you really don't want to do," said Dave Layman, the event coordinator for Medicare Rx Access Network.

The penalty, 1 percent for each month of not being enrolled, kicks in if a person chooses to stay with coverage that is not as good as Medicare Part D.

How do you know? Insurance companies are required to send all Medicare beneficiaries a letter saying whether they have "creditable" coverage -- or coverage that's equal to Medicare Part D.

At the Warwick Mall, Dr. Charlotte Yeh, the regional administrator for the Centers for Medicare & Medicaid Services, patiently went over the penalty with Blanche Jackson, 79, of Providence, whose husband died three weeks ago.

"The most important thing is to find out if your drug coverage now is as good as Medicare," Yeh said.

"If it's not as good, and you don't sign up for a plan by May 15, you have to pay a penalty. You don't want a penalty, right?" Yeh said.

Jackson sure didn't.

"The most important thing is to get that piece of paper," Yeh told Jackson.

"Where do I get that?" Jackson asked, her eyes wide.

"The plan is supposed to send it to you," Yeh said.

Fred and Terry Wilhelm, of West Greenwich, had just received such a letter, which is why they were talking to Delia Rodriguez, a counselor from the Department of Elderly Affairs.

Fred Wilhelm, who's retired from the field of fire-protection equipment, brought in a yellow folder of his paperwork. "They just sent us a letter saying it's not creditable," he said.

Rodriguez, on her laptop computer, walked the Wilhelms through a plan that Fred had researched. She explained "the doughnut hole," also known as the "coverage gap." After Fred has spent $2,250 on drugs, he will have to pay 100 percent of his drug costs until he's spent $3,600.

Fred was still unsettled. "I thought I'd walk in here, and say 'here's what I've got -- what's better' -- and walk out all satisfied," he said.

"Did I help in any way?" Rodriguez asked.

He paused, then gave a rather solemn nod.

As he left, he said the program was "little less confusing than it was an hour ago, but I told a friend of mine that if he hasn't got a Harvard law degree, he won't understand it."

Some people complained that the volunteers seemed to be still learning the program. "I know more about it than they did," said Henry Stad, 80, of East Providence, who had a Medicare goodie bag of literature at his feet and a sheet of his own math equations on his lap.

"It's horrendous," he said. "If the government tried to mess it up anymore they couldn't."

ONLINE RESOURCE: Find more information about the new Medicare Plan D drug -prescription plan, and how it affects you, at:

http://projo.com/extra/2005/medicare/