Millions to get Medicare applications

Officials, advocates fear many elderly will miss out on prescription benefits

June 02, 2005|By Ricardo Alonso-Zaldivar | Ricardo Alonso-Zaldivar,LOS ANGELES TIMES

WASHINGTON - Millions of elderly or disabled Americans who may be entitled to financial help through Medicare's new prescription drug benefit will receive applications for that assistance this month, Health and Human Services Secretary Michael O. Leavitt said yesterday.

About 14 million people - a third of Medicare's 43 million beneficiaries - are expected to be eligible for aid to reduce the program's premiums, deductibles and co-payments, which can amount to hundreds of dollars a year. For the poorest beneficiaries, such assistance could cover virtually all of the costs, officials say.

But the government and advocates for the elderly are concerned that many people will fail to apply for financial help.

Some may think their incomes are too high to qualify. Others may not want to fill out a six-page, 16-question application. And some may view the entire program - which requires them to select coverage from private plans under contract to the government - as too complicated to navigate.

"We are mounting an aggressive effort to find and reach those eligible," Leavitt said. "Every eligible low-income person will be better off by enrolling."

Under the drug plan, which takes effect Jan. 1, beneficiaries will pay the first $250 in costs, and Medicare will pay 75 percent of the next $2,000. Because of budget constraints, there will be no Medicare coverage for expenses between $2,250 and $5,100. Medicare will cover 95 percent of expenses above $5,100. Enrollment in the plan will begin Nov. 15.

To launch its current outreach effort, the government has enlisted the help of about 100 national organizations, including AARP, the American Medical Association and the National Council on the Aging.

"Telling people the government is here and they want to help is a difficult message," said Jane Delgado, president of the National Alliance for Hispanic Health. "We know people are inundated with information, but this is a matter of someone's life and health."

Enrollment is intended to be simple for the poorest beneficiaries. About 6 million elderly or disabled people who qualify for Medicaid - the states' health-care program for low-income individuals - as well as Medicare will be automatically signed up. Their annual out-of-pocket costs for prescriptions will be just a few dollars.

Some of the biggest concerns center on elderly people whose incomes are too high for participation in Medicaid, but low enough that they could be eligible for help with the Medicare prescription drug benefit.

Broadly speaking, single persons making less than $14,355 and married couples making less than $19,245 may qualify for assistance.

Medicare estimates that 7 million to 8 million people may be eligible for this assistance. To help find them, the Social Security Administration is sending applications to 18 million people who, based on their incomes, may possibly qualify.

Information and assistance is available on the Web site www.AccesstoBenefits.org, said David Lipschutz, a lawyer with California Health Advocates.

The Los Angeles Times is a Tribune Publishing newspaper.

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