Barely a month before Medicare recipients can begin saving money with new prescription-drug benefits, surveys show the myriad of options are still confusing many.

A state-sponsored report has been upgraded to help with the selection.

The Pennsylvania Health Care Cost Containment Council’s “Choosing a Medicare Managed Care Plan” compares plans by premiums, co-payment options and benefits, while showing what plans are available by county.

“This report was created to help explain the Medicare managed-care plan options that are available to older Pennsylvanians,” Marc P. Volavka, council executive director, said in a press release.

Plans listed include those with Medicare prescription-drug benefits, effective Jan. 1. Enrollment began Nov. 15 for new private-insurance plans.

But a survey released just before enrollment began shows most seniors don’t understand the prescription-drug benefits and only one in five was ready to sign up.

The survey, prepared jointly by the Kaiser Family Foundation and Harvard School of Public Health, shows barely one-third of seniors say they understand the new Medicare Drug Benefit “very well” or “somewhat well.”

Drug plans are available only through private insurance companies and Medicare recipients must choose a plan to be eligible for savings. Participants may select stand-alone prescription plans or managed care plans, including both Medicare HMOs or PPOs, which include prescription coverage.

The Cost Containment Council’s report compares HMOs, or managed care options.

It shows up to 31 different plans are available to seniors in Cambria, Somerset and surrounding counties. But not all plans are available in all counties.

Bedford County has the fewest options, with a dozen plans by three providers. At the other end of the spectrum, six providers offer a total of 19 plans in Westmoreland County, and Cambria is served by five companies, with 21 plans available. Not all include drug benefits.

The council’s report breaks down each plan. It shows monthly premiums and co-payments, benefits offered, and quality measurements like patient-satisfaction surveys and how each provider compares with national averages for providing preventative screenings and inoculations.

An independent state agency, the council compiles information about Pennsylvania health- care issues.

“For the fifth consecutive year, PHC4 is pleased to assist Medicare beneficiaries with this easy-to-understand guide,” Volavka said.

Medicare’s own comparison tool on its Web site, www.medicare.gov, shows all drug plans available. The same information is available at (800) MEDICARE.

But local senior advocates say family members should help with the selection process.

Despite a media blitz on the new drug programs, only half of seniors surveyed knew about the 800 number, and one-third were aware of the Web site.

Three-fourths said they have never been online. Only 6 percent have visited the Web site and 8 percent have called the hotline.

“Who is going to help them research it?” John Mavrodis, administrative officer, said at Cambria County Area Agency on Aging.

“They are going to have to rely on family and friends,” Mavrodis said.

State officials say the Cost Containment Council’s report is a good option for those who want all-inclusive Medicare coverage.

The council made the information available in printed form for Internet-wary seniors, spokesman Joe Martin said.

“Hard-copy versions of these new reports will have a place for county-specific inserts to help older Pennsylvanians navigate through the significant increase in plan offerings because of the new Medicare prescription drug program,” Martin said, announcing the update.

Many seniors who already have prescription-drug plans will be able to continue in those plans, and may even save money if the plan is becoming Medicare-approved, said Linda Choiniere, vice president for Medicare at UPMC Health Plan.

“It has given us the opportunity for some reductions,” Choiniere said.

Highmark Blue Cross Blue Shield also is reducing some premiums because of Medicare drug-plan subsidies, spokeswoman Denise Grabner said.

Three-fourths of seniors surveyed say the 40-plus prescription plans available make selection confusing, but Choiniere said options also create advantages.

“We think the good thing is, it has brought more competition into the marketplace,” Choiniere said. “Medicare beneficiaries have more choices.”



Randy Griffith can be reached at 532-5057 or rgriffith@tribdem.com.

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