Blitz for Drug Plan to Start Today

Health insurers will begin bombarding seniors today with advertising and phone calls touting their versions of Medicare’s new prescription drug discount plan, three months before the program goes into effect.

Starting Jan. 1, Medicare will offer outpatient drug coverage to its 40 million elderly and disabled beneficiaries. Insurers -- including at least 18 offering such plans in California -- can start marketing their programs today.

Companies including WellPoint Inc., Aetna Inc. and PacifiCare Health Systems Inc. say seniors will be able to select from a menu of generic and brand-name drug coverage at different premiums.

Despite a $300-million government education campaign also beginning this month, some experts fear that the insurers’ sales pitches could fluster seniors -- more than in 2003, when Medicare invited them to sign up for temporary drug discount cards.

“Seniors are going to be very confused,” said Bonnie Burns, a policy specialist with California Health Advocates, a Sacramento nonprofit for people on Medicare. “Some seniors are going to have to sort out if they are better off doing nothing at all. People marketing those plans aren’t going to be too concerned about that.”

David Friedman, chief operating officer for government programs at Woodland Hills-based Health Net Inc., which is offering three plans priced from $17.65 to $21.99 a month, agreed that some seniors would find the program confusing.

“We did focus groups in Los Angeles with seniors, and some were in tears when we tried to explain it,” Friedman said.

In California, the battle over the Medicare population is likely to be especially fierce, experts say. Seniors will probably see lower prices thanks to that competition

Some 10 companies have been approved to offer drug discount plans at the national level. Seniors in California can pick from a field of at least 18 insurers. Most have massive radio and network television advertising campaigns planned for this month, including one local insurer with ads featuring characters from the 1950s television show “I Love Lucy.”

The discount insurance program was signed into law by President Bush in 2003 and is estimated to cost as much as $700 billion over the next decade. Those eligible can sign up from Nov. 15 to May 15.

“We are telling people to sit back and take a deep breath” before making any decisions, said Cheryl Matheis, director of health strategies for AARP, an advocacy organization that represents more than 35 million Americans age 50 and older. “There is a lot of good in this for seniors. It is turning out to be more-generous coverage than people anticipated.”

Currently, Medicare beneficiaries pay full price for prescription medication or buy supplemental insurance to cover it.

Under the drug discount program, the Medicare administration is allowing insurance representatives for the first time to make unsolicited calls to potential clients. However, callers are not allowed to ask for financial information.

“This new opportunity for telemarketing is of grave concern,” said Julie Schoen, director of California Health Advocates. “Think of the vulnerable elders who may not understand their options and end up buying something that isn’t right for them.”

Mark McClellan, a Medicare administrator, said the government was making an unprecedented effort to educate seniors, hoping to avoid the kind of confusion that ensued after the drug discount card was developed three years ago. That program expires May 31 or the month after a Medicare recipient signs up for the new discount, whichever comes first.

Medicare will provide a handbook entitled “Medicare & You” to be mailed to beneficiaries in early October, an online tool at www.medicare.gov to estimate costs, and a toll-free help line at (800) MEDICARE, or (800) 633-4227.

Still, consumer activists worry that a provision of the plan could cause some seniors to lose some existing medical benefits if they make a wrong choice.

For example, a person who has purchased supplemental private coverage and also signs up for stand-alone Medicare drug coverage through another insurer would automatically lose the supplemental coverage.

“We’ll have warnings about that” on the enrollment forms, McClellan said.

Medicare officials also say patients will be able to restore coverage immediately if they lose it through this provision. To make its plans clearer for seniors, Health Net color-coded related prescription drug information and hired consultants to help design a magazine to explain its plan.

In two weeks, Cypress-based PacifiCare plans to launch its “Choice Is Swell” television campaign for its program, with computer-generated special effects featuring Fred and Ethel of “I Love Lucy.”

At Kaiser Permanente, Denise Hanson, director of Medicare for California, called the program “fairly complex” and said that “we expect there will be some confusion.” Hanson said Kaiser was mailing information to its roughly 800,000 eligible members and would embark on its own advertising campaign.