Medicare plans hit market today

Insurers can begin describing details of new drug programs

October 01, 2005|By M. WILLIAM SALGANIK | M. WILLIAM SALGANIK,SUN REPORTER

Starting today, seniors shouldn't be feeling lonely.

They'll be getting lots of mail. And invitations. And phone calls (unless they're on the do-not-call list).

This is the day private insurers can begin marketing their offerings under the new Medicare prescription drug benefit. Already some health plans, and some advocacy groups, have been sending out educational materials and conducting information sessions. What changes today is that the insurers can begin offering specific details -- such as premiums, deductibles, co-payments -- and pitching the virtues of their products.

There will be lots of information -- so much, some say, that it will lead to confusion -- as well as some aggressive salesmanship as companies chase an estimated 20 million to 30 million customers.

FOR THE RECORD - A chart in yesterday's editions of The Sun representing premiums for the new Medicare prescription plan contained erroneous numbers.
The Sun regrets the errors.

"At this juncture, the name of the game is market share," said Ron Pollack, president of Families USA, a Washington consumer-health advocacy group. "Plans will hustle as hard as they can to get people to sign up now."

Enrollment begins Nov. 15. The benefit starts Jan. 1 for seniors who sign up by then, although they have until May to enroll without penalty.

The choices will be complex. Federal officials announced yesterday that in Maryland there will be 19 insurers offering prescription-only plans, most with several options, and four insurers offering full Medicare health insurance plans such as HMOs and PPOs that include a drug benefit. Monthly premiums will range from zero for some of the HMOs to as much as $68.91.

But plans with low premiums aren't necessarily the least expensive overall.

Many plans will have a $250 deductible, but some -- generally those with higher premiums -- won't have a deductible at all. Some offer partial or, in a few cases, complete benefits for prescription costs between $2,250 to $5,100 a year -- a coverage gap in the standard Medicare benefit sometimes called "the doughnut hole." Different plans will charge different co-payments with prescriptions. Each plan will cover nearly all of the most popular drugs, but the drugs will be offered at different prices.

"Thanks to competition, these plan choices are very good news for people on Medicare," Dr. Mark McClellan, the administrator of the federal Centers for Medicare and Medicaid Services (CMS), said yesterday.

Consumers will be able to choose a plan with low monthly premiums, or one with higher premiums and no deductibles, he said. "If you don't want the so-called doughnut hole, you don't have to have it," McClellan said.

Within a few weeks, McClellan said, CMS will have interactive online questionnaires to help seniors make a choice by prompting them to enter their exact list of prescriptions and pharmacies they use. Staff at 1-800- MEDICARE will do the same thing over the phone 24 hours a day. Also, CMS will be mailing information booklets to seniors next week.

Avoiding confusion

Pollack, however, said the huge menu of choices would produce "a profusion of confusion." Seniors "will be bewildered and will have a hard time navigating," he said.

Pollack also said seniors should talk to local health insurance counselors -- in Maryland, each county has a program set up for this -- and not make decisions based solely on marketing pitches.

Marketers for the plans also expect some bewilderment. They say much of their effort will be devoted to educating seniors about how the benefit works rather than pushing their particular plans.

For example, Keith Langrehr, manager of advertising and brand development for CareFirst BlueCross BlueShield, said seniors who request information about his product, called Medi-CareFirst, will receive a "generic booklet" explaining the new Medicare benefit. There will be some information particular to Medi-CareFirst, he said, but it would be "90 percent general."

Thomas A. Curtin Jr., vice president of marketing for Kaiser Permanente Health Plans of the Mid-Atlantic, which is offering a Medicare HMO plan, said, "There's going to be so much noise in the market, we want to help provide some education when we can." While Kaiser plans some radio ads, those won't try to explain the complex tradeoffs of premiums and benefits. "It's hard to get that in a sound bite," Curtin said. "We'll just be pointing them to where they can get information."

Most of the insurers plan mailings. Some will do telemarketing. Many will do print and broadcast advertising.

The country's largest pharmacy chain, CVS, plans an information kiosk and a series of "Medicare Tuesdays," with extra help in each of more than 5,000 stores to give people a "guided tour" of the new benefit, said Jim Maritan, vice president for strategic and business development for the Woonsocket, R.I.-based chain. CVS isn't an insurer, but it has negotiated marketing deals with four of the big national plans.

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