Drug Benefit Goes Unclaimed

Only a fraction of Southern California seniors eligible to receive up to $1,200 in federal prescription drug credits have taken advantage of the opportunity, and time is running out.

Of the estimated 138,000 low-income seniors in Los Angeles County who qualify for the benefit, only 6,300 have applied for Medicare drug discount cards. In Orange County, 40,000 people may qualify, but counselors have been able to reach only 7,000 of them. Ventura County’s numbers are equally low.

Beneficiaries must apply for a drug card by Dec. 31 or they will lose half the prescription credit, part of a sweeping overhaul of Medicare.

Senior advocates say confusion over the discount card program, distrust, illiteracy and isolation are making it harder than anticipated to enroll potential beneficiaries.

“Frankly, these are not people you are going to meet in senior centers,” said Jacqueline Lauder, who heads up an Orange County campaign aimed at finding people who qualify. “You are going to get them through family and neighbors. It’s the lady down the street who never leaves her home and the nice old man who has language problems.”

Outreach workers across the country face the same problem. Of the more than 7 million older Americans with income low enough to qualify for prescription aid, only 1.5 million so far have taken advantage of the program.

In California, nonprofits, senior advocacy groups and government agencies are making one last push to get the word out.

“We’re at a fevered pitch, because we want people to maximize their benefit,” said Laura Trejo, a spokeswoman in the Los Angeles Department of Aging. “This is real money available to them.”

Under the Medicare reform law signed by President Bush last year, any beneficiary can apply for a drug discount card. The cards are a temporary benefit that may help seniors save money on drug costs until Medicare’s prescription drug coverage takes effect in 2006.

Part of the discount card program, the $1,200 credit is available to individuals with an annual income of less than $12,569, or couples living on less than $16,862 a year.

Seniors with higher incomes should also apply, a federal spokesman said, because a Medicare-approved discount card might save them 15% to 20% on prescriptions in 2005.

“It won’t affect any of the coverage you already have, and you might qualify for discounts even if you don’t qualify for free coverage,” said Gary Karr of the U.S. Centers for Medicare and Medicaid Services.

With 4.3 million Medicare recipients, California has been a primary target for campaigns aimed at educating seniors about the benefits of discount drug cards, Karr said.

The federal government operates a telephone hotline, (800) MEDICARE, to start the enrollment process. But the work of local agencies is crucial, Karr said.

“Voluntary health programs take a while to get down to the street level,” he said. “You can’t do it all with a big megaphone in Washington, D.C.”

The first discount cards became available in the summer. Out of 41 million Medicare beneficiaries, an estimated 6 million have enrolled in the drug discount card program.

Numbers are low, Karr said, because two-thirds of seniors already have some kind of drug coverage. And in California, most of those covered by Medi-Cal do not qualify.

But community leaders say some seniors are unsure which card to choose and are put off by an application process they see as unwieldy. The process involves selecting from up to 40 card sponsors, filling out a form and mailing it to the appropriate card sponsor.

Even with helpful websites, it can be overwhelming for older people, said Eileen Harper, spokeswoman for a Medicare counseling program in Los Angeles.

“Only 20% of the older adult population uses the Internet, where most of the information is available,” Harper said. “Most people have received a packet of information, but they still need help.”

Seniors also are worried that if they sign up for a drug discount card, they might lose their other insurance coverage, a common misperception, said Katharine Raley of Ventura County’s Area Agency on Aging.

Helen Simonaitis, a Realtor from Ventura, said her elderly mother tosses solicitations into the trash because she worries about falling victim to a scam.

“They’re all printed with logos in red, white and blue and look real important,” said Simonaitis, who attended a recent information forum in Ventura that drew only six people. “There is a lot of mistrust.”

To reach non-English speakers, advocates have gone on Spanish-language television and radio and have had stories published in Spanish-language publications, said Amy Atlas of the Los Angeles Access to Benefits Coalition.

Printed materials are available in several languages, including Spanish, Korean, Chinese and Vietnamese, Atlas said.

In Orange County, elderly shut-ins were given printed information with hot meals delivered to their homes, Lauder said.

Orange County officials have also trained hundreds of staff members at nonprofit groups to counsel seniors and help them fill out applications, Lauder said. Their biggest response came after an interview on a Vietnamese-language radio station, she said.

“We tell them that if they are paying any money for drugs, call us to see if you qualify,” she said. “No one is turned away.”

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More information

For referrals to Medicare counselors in your area, call:

(800) 510-2020 (in Los Angeles, Orange, Riverside and San Bernardino counties)

* (800) 434-0222 (in Ventura County)

* (800) 633-4227 (in San Diego County)

* For help comparing Medicare-approved drug discount cards, visit: www.accesstobenefits.org

* For an application packet or questions about the Medicare-approved drug discount cards, call: (800) MEDICARE

Los Angeles Times