The new Medicare prescription drug plan that goes into operation in January is one of the most complicated federal benefits ever devised, and senior citizens by the tens of thousands have been shying away from signing up. But not to worry, federal officials say, they’ve developed a system called Plan Finder to make everything simpler -- a kind of magic decoder ring to melt away the confusion and help seniors save money.
There’s just one catch: The system is designed for people who have no problem getting onto the Internet via computer -- something fewer than one-third of all elderly Americans have ever done.
If navigating the Internet is not challenge enough, those who get to the medicare.gov website must type and mouse-click their way through screen after screen of questions, boxes to check, and other options.
They must feed in personal information, including the drugs they take and the pharmacy they use. Only then do they get a personalized list of available plans, with their main characteristics spelled out and their costs ranked from lowest to highest. That, experts agree, is where the real comparison shopping should begin.
To computer wizards, or the Xbox Generation grandchildren of today’s senior citizens, all this would be child’s play. “It’s neat -- it’s well done,” said 35-year-old Susannah Fox, associate director of the Pew Internet & American Life Project.
But the aging, computer-challenged customers that Plan Finder is intended to help may disagree. “For someone who is computer savvy, I would probably give [Plan Finder] a B,” said Marlene Eskin of Austin, Texas, who is 70 and works as a marketing consultant. “For the audience they are directing it to, the majority of whom may not even have a computer, I would give it a D. I think that’s the group it needs to work for.”
At one level, it may seem all too predictable that the government, which many Americans consider the leading producer of red tape, proposes to deal with the red tape of the prescription drug plan with an online help system that is the dot-com equivalent of more red tape.
But there’s nothing funny about the potential consequences. The Medicare prescription benefit is a small but pioneering step toward helping large numbers of Americans cope with the ever-increasing cost of healthcare. It is also one of the proudest domestic policy achievements of the Bush presidency. Yet the complexities of the plan have thus far discouraged so many senior citizens from signing up that the success of the overall plan is in doubt.
If Plan Finder or something like it does not change that situation, the result could be a major setback in the quest for improved healthcare.
And the problems with Plan Finder seem to range from its technical difficulties to cultural disconnects between its designers, who are comfortable with the conventions of the online world, and its intended users, who frequently are not.
Muriel Bennett, for example, is a retired small-business owner from New York who uses the Internet to look up book and theater reviews and to research medical topics. But the prospect of plugging private information such as her Social Security number into Plan Finder leaves her cold.
“I don’t like putting any personal information in,” said Bennett, who is in her 80s. “I have never put in my credit card number. And I’d sooner put my credit card number in than my Social Security number.”
Recent surveys show that 23% to 30% of seniors go online, compared with more than 70% of all Americans. Like Bennett, many of those seniors tend to be cautious about feeding personal data into a system they don’t fully understand or trust.
And for many who need the new drug plan most, those in frail health with serious medical problems, just gaining access to a computer and manipulating its keyboard and mouse may be difficult if not impossible.
Even some of those responsible for creating the new system acknowledge the difficulties.
“The average senior probably has to have some help in navigating it. I had to do that with both my parents,” said Michael Cho, 42, president of Los Angeles-based DestinationRx, which developed Plan Finder for Medicare. “Like anything new, it’s an intimidating process.”
The goal of the prescription plan is to let seniors buy private insurance plans that fit their individual needs. The difficulty is that the plans offer a bewildering number of choices. Different plans have different premiums, different co-payment requirements, different lists of covered drugs and different prices for their drugs.
That complexity is what Plan Finder is designed to cut through.
Taking information about an individual, the system sorts through available policies and charts how they compare in costs and benefits.
“The Plan Finder is the best and only available tool” to pick a plan, said James P. Firman, president and chief executive of the National Council on the Aging. “It’s very difficult to do this without the [Internet] tool because of the number of nuances in the decision. The [computerized] tools are smarter than the individual.”
Federal officials say the Medicare prescription plan is a good deal because the government will pay about half of the typical beneficiary’s costs. And Plan Finder offer seniors more powerful technology than most working-age people have when shopping for health insurance, said Mary Agnes Laureno, director of beneficiary information services for Medicare.
Plan Finder “is pretty unique -- we are pricing even down to the pharmacy of your choice,” Laureno said. “Even if only 25% of seniors are actively using the Internet, that is still 11 million people, and that is a lot of people.”
Firman’s organization considers the benefit and Plan Finder so important that it is sending squads of tech-savvy helpers armed with laptops and traveling in special vans to assist seniors around the country. In Southern California, the white-and-green “My Medicare Matters” vans are scheduled to arrive by early December in Los Angeles, Riverside and San Bernardino counties.
Government officials point out that the Internet is not the only way to access Plan Finder. Seniors can also call (800) MEDICARE, where a benefits agent will use Plan Finder for them and mail them a printout. So far, the average time on hold is less than two minutes -- five minutes during peak hours in the evening -- Laureno said.
Yet if the experiences of some seniors are any guide, Medicare’s benefits agents may be able to help with some questions but stumped by others.
Frank Glaser, 73, a retired engineer from Rancho Palos Verdes, said he had spent long hours online exploring the system. “The Plan Finder is the Rosetta stone -- once you can use it, you have the magic key,” Glaser said. “But I’m sitting here, having put a lot of hours into it, and I still have huge questions.”
For example, he found that the list of plans generated by the system can include some that don’t cover all the drugs a senior takes. It takes additional work to sort that out.
Glaser said he also had found a $1,000 difference between the cost Medicare quoted for one plan and the price cited on the insurer’s website.
Marlene Eskin said she was frustrated because the system did not rank plans by those that offer coverage in the so-called doughnut hole. The hole is a coverage gap between $2,250 and $5,100 of total drug costs, where seniors must pay their own way. Some plans bridge the coverage gap in exchange for a higher monthly premium. Finding those plans requires additional online research.
Margaret Dowling, 65, of Pittsburg, Calif., had another problem: seeing letters and numbers in drop-down boxes on the website, which seniors must use to enter their Medicare eligibility data. Even using an optional magnification feature, she still had trouble. “Don’t you think it should be accessible to everyone?” she asked.
Medicare’s Laureno said she agreed with Dowling’s criticism and would take up the matter with the contractor.
Consumers Union, publisher of Consumer Reports and one of the pioneers of comparison shopping, has been watching Plan Finder closely. “I think it is a very powerful tool that will be very helpful to those Medicare beneficiaries who can successfully access it,” said Gail Shearer, a health policy specialist with the group. “But at the same time, it doesn’t answer all the questions.
“The big picture here is that the underlying legislation created a very complicated benefit,” she said. “Congress needs to make some changes so Medicare beneficiaries can have simpler options.”