Web tools may help sort out Medicare drug plan

By Lisa Baertlein

LOS ANGELES (Reuters) - Senior citizens, sharpen your pencils and fire up your computers -- open enrollment for 2007 Medicare prescription drug coverage begins November 15.

Next year offers a bigger selection of Medicare Part D coverage, and many existing plans are being tweaked.

So, to avoid any unpleasant surprises or administrative glitches, experts strongly recommend that all seniors -- even those who are satisfied with their present coverage -- do their homework and make their decision a couple weeks before the December 31 cutoff.

"Plans are changing. Some for the better, some for the worse," said Patricia Newman, who directs Medicare policy work at the Kaiser Family Foundation in Washington, D.C.

Her advice: "Go back to the drawing board. Compare plans once again. Read the fine print. Make sure the plan you choose for 2007 is the best for you."

Last year's addition of prescription drug coverage was the most sweeping change in the 40-year history of Medicare, the U.S. government's health insurance program that covers 43 million people who are disabled or over the age of 65.

Medicare takes care of 99 percent of the people who are eligible. About 38 million Medicare users have signed up for drug coverage thus far.

In an effort to ease some of the pain of wading through what can be a confusing and overwhelming amount of information, the government has enhanced online tools that help users do side-by-side plan comparisons and personalize their research.

Jeff Flick, regional administrator for the Centers for Medicare & Medicaid Services in California, Arizona, Nevada and Hawaii, said the formulary finder on Medicare's main Web site at http://www.medicare.gov/ is a good place to start.

A formulary is a list of drugs that are available through a prescription drug plan. Users who click on the formulary finder option will be asked to enter the state where they live and then to type in all of the drugs they are taking. It will also direct users to plans that cover their drugs, and suggest generic alternatives.

A new link on the main Medicare site -- "Compare Health Plans and Medigap Policies in Your Area" -- allows users to weigh the benefits of original Medicare against plans from private insurers.

Those who are interested only in drug plans can click on the link "Compare Medicare Prescription Drug Plan" on Medicare.gov. From there, they can compare options, enroll and view current plan information.

The comparison tools also allow users to check other plan information, such as whether they can choose their own doctors or if there is coverage in the "donut hole" or "coverage gap" -- the span when insurance plans stop paying and "catastrophic" coverage has not yet kicked in.

Other new links connect users to tips for lowering costs during the coverage gap and to a digital version of "Medicare & You 2007" information booklet.

Flick said MyMedicare.gov, at http://www.mymedicare.gov/, is a new site where users can store and update prescription information, check drug prices, track claims and find detailed information on preventive health benefits.

RALLY THE GRANDCHILDREN

Flick and others acknowledge that only a small percentage of Medicare recipients are regular Internet users.

"Call your grandson or granddaughter," he said, encouraging seniors to tap family members, friends, neighbors and state or nonprofit groups for assistance.

Kaiser's Newman said Medicare.gov is really the only central repository for information on all of the plans.

She added that the same data is available through Medicare's 24-hour 1-800-MEDICARE hotline, which is a good option for people who are not computer savvy, although it can be more time-consuming and cumbersome.

State health insurance programs, known as SHIPs, and other nonprofits have deployed an army of people who can provide unbiased, one-on-one health counseling. A list can be found at http://www.medicare.gov/contacts/static/allStateContacts.asp.

Florida, which has the highest percentage of elderly of any state at nearly 23 percent, calls its program SHINE. It can be found online at http://www.floridashine.org/.

While Medicare's site offers information on drug coverage not found elsewhere, David Lipschutz, staff attorney for California Health Advocates, http://www.cahealthadvocates.org , said some consumers have discovered inaccuracies.

He said shrewd Medicare shoppers will discuss their choices and best options with an unbiased counselor in addition to doing online research and verifying the accuracy of plan information with insurance providers.

"Online tools supplement other tools -- in no way are they an end all be all of research or homework that beneficiaries have to do," Lipschutz said.