Denny Dowd of Lancaster County Office of Aging said thousands of seniors sought her office's help choosing a prescription plan in recent months. But on Monday, she estimated her office enrolled about 100 or so.

"We probably had about 200 phone calls (Monday) alone," Dowd said. "A lot of people didn't want to be forced into doing something, so they waited until the last minute to make sure they needed to be enrolled in the first place."

Those with prescription coverage through the Veterans Administration, an employer or other means may have elected not to enroll in the Medicare plan.

Those who didn't enroll by the deadline face a penalty when they do enroll of 1 percent of the monthly average cost of premiums in the nation, which is $32. A 32-cent monthly penalty might not sound like much, but it accumulates for the rest of your lifetime.

"It can be a sizable penalty because it is cumulative," Dowd said. "It's a penalty that follows you for life, so if someone waits five years to enroll, it accumulates."

That penalty doesn't apply for those who can prove their prior coverage was as good as or better than what Medicare offers.

The next chance to enroll with a Medicare provider is Nov. 15 through Dec. 31. But Dowd said a 74 percent target for the county -- a goal set by the Centers for Medicare & Medicaid Services for this enrollment -- probably was met in the 11th hour by last-minute enrollments.

Plenty of seniors signed on Friday at a three-hour seminar at Lancaster General Health Campus.

"We were running at about 30 people an hour for the first two hours while I was there," Lancaster General spokesman John Lines said. "I would venture to say the pace stayed that way until way past 1 p.m. We had one guy who showed up at 7 a.m. -- and they didn't even start until 10 a.m. We asked him why he showed up three hours early, and he said he wanted to be the first in line. For some seniors, this is a big deal, and they gave it an awful lot of thought."

They had to. Similar seminars have been held across the country since last April, when details of the plan were first unveiled in thick booklets mailed to seniors and television and radio ads cautioning them to enroll before they suffered penalties.

At a Lancaster General seminar late last year, more than 300 showed up to learn more about the complicated system. In spite of standing-room-only crowds, the room still was filled with people asking questions well after the seminar ended hours later.

Of the 40 or so insurance plans available to seniors in this area, each charges a different monthly premium, and each covers different medications at different rates and only at specific pharmacies. So the challenge of enrolling in Part D is to find a plan that saves money will best work for the specific medications and pharmacies a person uses. And even those details are subject to change.

Seniors who enrolled are locked into their plan for a year, so making an educated choice is vital, especially because a senior who chooses unwisely could end up with a plan that charges a monthly premium and doesn't cover their medications at all. On top of that is the dreaded "donut hole": a gap in coverage between $2,250 and $5,100, for which enrollees must pay out-of-pocket.

Not everyone is convinced Plan D was much of a plan, and some bitterly criticize its architects for penalizing seniors, especially when choosing wisely meant taking a long look at the options and coming to a rather sophisticated understanding of them.

"To punish seniors until they pick a program is immoral, especially because the legislation (that created Part D) was very flawed," said Julia Ramsey of Pennsylvania Action, a state partner of Americans United, a group that has urged legislators to extend the deadline, drop financial penalties and design a plan for Medicare to provide coverage to seniors directly rather than through private insurance companies.

Another advocacy group, Pennsylvania Alliance for Retired Americans, calls for similar changes.

"We don't think there is anything lost by extending the enrollment without penalty, at least to the end of the year," said spokesperson Dani Pere. "The deadline was May 15, so it forced 2 million more seniors to sign up. That's the equivalent of putting a gun to a senior's head and saying they must make a decision."

Apparently, many local seniors agree. Lines said a lot of seniors came to Friday's seminar asking if a deadline extension was in the works or if Medicare had decided to waive penalties.

"They were hoping beyond hope that they would have more time or wouldn't incur a penalty if they couldn't come to a decision," Lines said. "Time will tell about the real benefit. The plan is really being put to the test now."

For those who bit the bullet and enrolled in Medicare Part D, the next year should be telling.

"We're going to see two real hurdles in the next couple of months: People will start to see if the plans aren't working for them, and they'll start reaching that range where they're paying out of pocket," Ramsey said. "Seniors have been scared into signing up for it, but as a whole, they don't trust it. They'll be very quick to make up their minds if it's not working out for them."

"For some seniors, this is a big deal, and they gave it an awful lot of thought."

John Lines

LGH spokesman blog comments powered by Disqus