No pain, no gain

December 28, 2005

Bellyaching and worse over Medicare's relentlessly confusing new prescription drug benefit is likely to be a prime feature of the coming congressional election year, as elderly Americans try to make sense of a program intelligible only to the mentally nimble and computer-savvy.

But as the program's Jan. 1 debut draws near, Medicare beneficiaries and their families should put aside their complaints and tackle the task. Millions of older Americans with whopping pharmacy bills and no current drug coverage are eligible for substantial help beginning then, but they must sign up before to qualify.

As of mid-December, fewer than one-tenth of the 12 million or so people who have the most to gain from Medicare's new drug benefit had enrolled in the program. That's a wasted opportunity. They have until May 15 to sign up without penalty, and can begin getting benefits earlier if they enroll earlier. But it makes no sense to wait.

The new drug program, known as Medicare Part D, suffers from trying to be all things to all people. It is at the same time too expensive and too stingy, a good deal for some and a bad bargain for others, loaded with choices but few easy answers.

Heroic efforts have been made by public and private agencies that serve the elderly to help them through the maze. But the shortest, easiest route is through the Internet, which 75 percent of the target beneficiaries don't know how to use.

The threshold question for each individual, says Rep. Benjamin L. Cardin, a Baltimore Democrat who, like most of his House colLeagues, has been conducting town meetings on the topic, is to determine if he or she needs the new drug benefit.

For those who already have drug coverage through an employer or the military, the answer is almost certainly no. By contrast, the need is so obvious for low-income elderly people who as of Jan. 1 will lose their drug coverage through Medicaid, they have been automatically enrolled in the new Medicare program.

Folks who have some drug coverage or no drug coverage but take few medications have a more difficult decision that requires homework and probably some help.

There's no reason to panic, but don't put it off. Shop now; your savings may only be days away.

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