Critics Fault Medicare Handbook
Draft Explanation of Drug Plan Sows Confusion, They Say
By Ceci Connolly
Washington Post Staff Writer
Saturday, May 7, 2005; Page A07
As they gear up to sell the new Medicare drug benefit to 43 million seniors, federal health officials are circulating a draft handbook that elder advocates and insurers say is sprinkled with omissions, inaccuracies and material that could make an already complicated endeavor even more confusing.
The most glaring omission is the absence of any mention of the coverage gap euphemistically dubbed the "doughnut hole." Though it was one of the most contentious elements of legislation creating the new benefit, the draft makes no attempt to inform retirees that in most cases coverage will stop once they have spent $3,600 of their own money and will not resume until those out-of-pocket costs reach $5,100. A senior who purchases medication during that window would likely pay the entire cost.
The handbook, "Medicare & You," also fails to explain that most prescription drug plans will limit which medications are covered, a system known in the private sector as a preferred drug list or formulary, according to reviews submitted by a range of interest groups. The 100-page document also introduces unfamiliar terminology, such as "creditable coverage," provides misleading information about how often beneficiaries can switch insurance and uses income figures that conflict with material being distributed by the Social Security Administration.
"The web of choices facing people with Medicare is challenging to explain and comprehend," wrote analysts at the independent Medicare Rights Center. "But we believe that the draft handbook makes these choices even more difficult to understand, rather than less."
Beginning Jan. 1, 2006, Medicare will offer prescription drug insurance, either as an add-on to the government's traditional fee-for-service or as part of a comprehensive managed care plan. The design and contents of the handbook are critical to helping elderly beneficiaries navigate the maze of choices....
http://www.washingtonpost.com/wp-dyn/content/article/2005/05/06/AR2005050601422.html