Medicare prescription plan may not be easy to swallow

WASHINGTON — Medicare officials on Friday unveiled the final design for a prescription drug benefit that will take effect Jan. 1, 2006, promising savings of hundreds of dollars for a typical middle-class beneficiary.

But officials acknowledged they face widespread confusion and skepticism among retirees over how the voluntary plan would work — and even whether it is worthwhile.

Medicare Administrator Mark McClellan said a $300 million campaign is being launched to educate 42 million elderly and disabled beneficiaries about their options. About 6 million beneficiaries who have very low incomes or are in nursing homes will be enrolled automatically.

The success of the effort should play a large part in determining whether the new benefit — a major Bush initiative that the president spotlighted during his re-election campaign — becomes a valuable addition to the bedrock health program or turns into a politically embarrassing flop.

"If you look at surveys, there are a lot of beneficiaries who don't know they're going to have a drug benefit available to them," McClellan said. "Our first goal is to get the basic facts out."

The AARP, which has backed the Medicare prescription plan, pledged Friday to help make it a success.

"This is the biggest domestic policy initiative the administration has got, and if it doesn't play out as hoped it could really be a black eye," said John Rother, AARP's director of policy. "AARP has got something riding on this, since we supported the legislation. But the whole point is to get a drug benefit into the hands of millions of seniors."

Much of the concern about the drug plan stems from its differences with existing Medicare benefits. Unlike those, it won't be provided automatically to the majority of beneficiaries.

Instead, most retirees who are not poor or confined to nursing homes will be required to make a series of decisions, starting with whether they want to participate at all. Coverage will be provided through private plans, requiring beneficiaries to shop around and compare potentially complex variables such as co-payments and drugs covered.

"Getting 42 million people to take action is a monumental task," said Tricia Neuman, a Medicare expert with the nonpartisan Kaiser Family Foundation.

Some patient advocates said Medicare has not done enough to require drug plans to disclose detailed information to prospective members.