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Changing Medicare Plans

First in a two part series on Medicare Part D and the different experience of different income groups in the transition.

Springfield resident Marcia Dake is optimistic about her recent switch to the Medicare Part D Prescription Drug Program.

An original resident of Greenspring Village, a retirement community developed roughly seven years ago and managed by Erickson, a Maryland company, Dake changed her medical coverage from AARP to a plan specific to Erickson community residents.

Greenspring has more than 2,000 residentsÕ age 62 and up, according to its official Web site. Each Erickson campus is supported by Erickson HealthSM, an integrated wellness and health care system for people over the age of 62. To live in the community residents must pay a refundable Òentrance depositÓ that can range from $100,000 to $464,000, depending on the type of apartment they choose. Residents then pay a monthly fee averaging from $1,300 to $2,000 per month for the various amenities provided on campus.

At the end of last year, the Springfield campus gained national attention when President George W. Bush visited residents in an attempt to promote the new Medicare Part D Prescription Drug Program.

"He was very personable," said fellow Greenspring resident Eloise Cartwright. "I will remember that [visit] for a long time. You don't get to meet the president very often."

During his visit the president urged residents to enroll in the new plan before its May 15, 2006 cutoff date.

Realizing she could save a considerable amount of money each month, Dake took the president's suggestion.

Formerly covered under a Medigap plan through AARP, Dake used to pay $260 a month, with a small portion of that cost covering prescription drugs. For the rest of her medication she would pay roughly $2,000 to $3,000 a month out of pocket.

"I am hopeful and I'm fairly confident that what we have now will be improved," she said about the new Medicare Part D plan.

IN THE ALMOST two months since the Medicare Part D Prescription Drug Program went into effect, Dake has had no problems, although she says itÕs too early to tell how much money she will save with her new plan.

Medicare prescription drug coverage is insurance that covers brand-name and generic prescription drugs. Medicare prescription drug coverage also provides protection for people with high drug costs.

To help people paying high drug costs, Congress Ñ at the urging of President George W. Bush Ñ enacted into law the Medicare Part D Prescription Drug Program in 2003. Beneficiaries began enrollment Nov. 15, 2005. For people enrolled by Dec. 31, 2005, coverage began Jan. 1, 2006.

Eligible citizens who have not registered for the plan have until May 15 to enroll before a 1 percent premium surcharge is added for each month they do not enroll.

Compared to other states, Virginia has not had a lot of problems with the switch over, said Nancy Malczewski, spokeswoman for the Department of Medical Assistance Services.

During the first month the department's call center, specifically set up to handle Medicare questions, received 195 calls. During the second month the center received 114 calls, Malczewski said.

"We tried to put out information ahead of time and we offer updates when things change," she said about how the department is handling the switch.

CARTWRIGHT, a good friend of Dake, also made the switch to a new plan.

Not familiar with the computer, Cartwright admitted the thought of using the Medicare phone systems was overwhelming because of the wait times and the various phone numbers to be called.

Instead Cartwright enlisted the help of a computer-literate friend, who entered her information into the official Medicare Web site. From that she received a list of applicable plans, and chose the one best for her, she said.

Not wanting to disclose how much money she spent a month on her five prescriptions, Cartwright would only say she was spending a "considerable amount of money."

"I was looking for some relief from the increasing bills that I have," she said. "I am just thrilled. I am going to save considerably."

Anticipating complications among residents, the pharmacy staff of Neighborcare Pharmacy at Greenspring Village took a pro-active approach, said Ellen DeMucci, pharmacy manager.

This included holding Medicare workshops for residents and working one-on-one with them to ensure they were enrolled in the proper plan.

"I can't expect these 88-year-old people to push one, push zero and then hear 'your estimated wait time is 42 minutes,'" said DeMucci.

Because most Greenspring residents are financially stable and not dual eligible Ñ eligible for Medicaid Ñ there have been few problems since the switch, DeMucci said. Low income seniors have a more complicated transition.

Problems she has seen are usually due to miscommunication at higher levels of the program. A small percentage of the enrolled residents did not receive their Medicare cards by Jan. 1, when their plans became active, she said. Without the Medicare card, the patient could not get their prescriptions filled.

To remedy problems, DeMucci and her staff would call the Medicare hotline. In the beginning, wait times would range from 40 minutes to two hours. DeMucci's longest wait time was two hours and 12 minutes, she said.

"The feedback [from residents] so far has been very positive," DeMucci said. "But, right now everybody has rose-colored glasses on and everything is wonderful."

Next week, a look at how some low-income clients of the Fairfax-Falls Church Community Services Board have fared in the transition.