Elderly, disabled begin new Medicare era

WASHINGTON — Medicare's prescription drug coverage rolls out today, a benefit being hailed as the most significant advance in the program's 40-year history.

Most senior citizens should see their medicine become more affordable because of the new coverage. Still, not everyone will save, and Medicare's 42 million beneficiaries have been patient, if not hesitant, about enrolling in a private plan.

Dr. Edward Langston, a family physician from Lafayette, Ind., says the elderly make up about a third of his patient load. The most common question he gets from them is, "Do you think I should sign up?

His reply: "Certainly."

"My average Medicare patient has heart disease, diabetes, arthritis, and then a few other things you want to throw in there," Langston said. "They're the most vulnerable patients we have out there except for the infant. We have some excellent drugs to help treat them, but a lot of them have fixed incomes, and they need the help."

The best way to ensure that people get the most out of the new coverage is to find the private plan that best suits their needs. It's a task that takes time and effort.

People can compare plans on their own through the government Web site www.medicare.gov or they can call 1-800-Medicare and get an operator to do the comparison for them.

In each state, beneficiaries can choose from among dozens of plans. Those offering drug coverage include the biggest names in the health insurance industry. In Langston's state, for example, there are 42 private plans offering prescription drug coverage. The choice increases even more when including Medicare Advantage programs. Those programs operate like an HMO and offer more comprehensive medical coverage, such as visits to a doctor.

All the choices have proven daunting for some senior citizens, but government officials counter that choice is good. The competition drives down beneficiaries' expenses and improves benefits, they say.

"Choice can be baffling when it's hard to tell the differences between the different plans," said Diane Rowland, executive vice president of the Kaiser Family Foundation, a research organization. "I think for people who don't have coverage, who are very low income, this is an important supplement to their Medicare coverage. But people above the low-income subsidy really have to look at the plans closely."