How to fill out Medicare drug form

Remember that "extra help" form you got from the Social Security Administration as part of the federal government's new Medicare Part D program a few months ago? The form you may have tossed in the garbage thinking it didn't apply to you because your annual income was over the limit?

You need to fill out that form even if you expect to be rejected to maintain your status in the state's prescription drug program, which will be called Illinois Cares Rx as of Jan. 1. The federal form doesn't say that, but that's the case in Illinois, said Marge Zajicek, a resource manager at Senior Services of Will County.

Zajicek and Dick Sefton, a state-certified Senior Help Insurance Program counselor in Morris, are both trying to get the word out to seniors in these programs."A lot of these people in their 80s just don't read these letters well," Sefton said. "They don't think they're important, and they don't like change."The form tells people not to continue filling it out if they earn over the allowable amount. But Illinois seniors in Senior Care and Circuit Breaker must do it anyway.

"If you didn't do it do it," Zajicek said. "Come on in. We'll do anything we can to help you."Zajicek has forms at the center, 251 N. Center St., Joliet.That is just one of many complicated issues surrounding the federal government's new Medicare Part D prescription drug program, which kicks in Jan. 1.Enrollment starts Nov. 15 and more and more seniors are seeking help with the program as the date approaches.

"We're getting 60 to 70 calls a day," Zajicek said.Sefton also is being inundated with requests for assistance."In the last two weeks it's getting wild," he said. "It's getting to be crunch time."Sefton has categorized seniors seeking help into three groups:

• People who belong to the state's Senior Care and Circuit Breaker prescription drug programs. Remember, these people must fill out the Social Security Administration's extra help form to remain in the state's prescription drug program, soon to be called Illinois Cares Rx.
• People who have prescription insurance through their employers or unions. These people will be receiving a letter in the mail telling them if their existing prescription drug plan is "credible." That means their plan is equal to or better than the Medicare Part D offerings.Seniors should keep this letter on file so that if their plan ever ends, they can enroll in Medicare Part D with no penalty, Zajicek advised."Make a couple of copies and put one between the mattresses," she said.If your plan is not credible, then you can sign up for Medicare Part D coverage. Seniors who receive Veterans Administration benefits can sign up for Medicare Part D programs to supplement what they have.
• Self-employed seniors who make too much money for the Senior Care or Circuit Breaker programs. These people need to sign up for Medicare Part D coverage if they want prescription insurance.

No one has to sign up for coverage, Sefton said. But people who don't sign up by the May 15 deadline will be penalized 1 percent per month if they sign up later.For instance, if you are healthy now and take few if any drugs you could choose to opt out. But five years from now if you are ill and need coverage, it will cost 60 percent more to enroll, Sefton explained. After May 15, enrollments will only be accepted from Nov. 15 through Dec. 31 for coverage the following year.

Sefton said a friend of his who had bone cancer was taking a medication that cost $4,000 a month before he died. Though seniors will have to pay prescription costs from $2,250 to $5,100, Medicare Part D will help immensely with catastrophic illnesses, Sefton said, because the program covers 95 percent of costs after $5,100. Also, people who sign up for one of the inexpensive plans can always switch to a more comprehensive plan later. "You hope you never have to use it, but if you do, then you can upgrade the plan and not pay the penalty," Sefton said.

In Illinois there are 16 companies offering 52 plans to choose from, Zajicek said. Plans range in price from $13 to $55 a month.Medicare was supposed to have a feature up and running on its Web site Monday (www.medicare.gov) to help seniors choose from among the plans. But that option was not working as of Monday afternoon, Zajicek said. Once it's up and running, medications and dosage information will be entered into the program and the site will list the best insurance plan choices based on specific prescriptions.

State Rep. Renee Kosel, R-New Lenox, said the large number of plans to choose from is one of the most confusing aspects of the new federal program.Kosel is concerned that some seniors could be scammed by companies taking advantage of the confusion. She's working with state agencies to make sure seniors know where to get official help.Kosel also is holding seminars in the region to help seniors make the right choices. The next one is at 10 a.m. Nov. 22 at the Orland Park Civic Center, 14750 Ravinia. "It's affecting so many seniors, we're trying to get the experts out to help them," Kosel said.

Even Kosel has had trouble grasping all of the angles of the new program. She said she's been helped by her own seminars."I've listened to the presentation three times and I kind of understand it," she said.

Sefton said the Medicare Part D program is so confusing, many seniors who come to him for help are asking him to make choices for them, which he cannot do. He can only present options for them.The saddest cases are the widows whose husbands handled all of the couple's financial affairs for years."They're just completely bewildered," he said.

Source: RefillPill.com Editors' Choice