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Painful

Few options left for those who didn't sign up for Medicare discount drug coverage.

For Maria Valenzuela, the new Medicare drug subsidy program meant countless hours of research and a daunting deadline.

The new benefit, also known as Medicare Part D, helps pay for prescription drug costs for those with Medicare, and for Valenzuela, the enrollment process quickly turned into a family affair.

After becoming aware that Medicare was expanding its benefits to cover prescriptions, Valenzuela sought the assistance of her daughter, Mary Lou, who had to quickly become familiar with all aspects of the program.

And with a mid-May enrollment deadline, Mary Lou knew there was no time to waste. But many challenges lay ahead for her and her mother. Those who didn’t beat the deadline would be out of luck.

"Almost all of the information my mother received on Medicare Part D was in English," says Mary Lou. 30. "That was challenging for my mom, as she reads, writes and speaks primarily Spanish."

After countless hours of online research and phone calls to plan carriers and local Medicare offices, Mary Lou slowly navigated her way through the ins and outs of the program’s provisions and prescription plans.

With so many plans available, selecting the one that best fit her mother’s needs was no easy task.

"Numerous plans sent brochures and post cards multiple times throughout the enrollment period. But without the information being available in your native language, in my mom’s case Spanish, the entire process became intimidating."

According to plan provisions, everyone with Medicare is eligible for this coverage, regardless of income, resources, health status or current prescription expenses.

This Part D coverage covers both brand-name and generic prescription drugs at participating pharmacies, with each plan providing access to medically necessary prescription drugs.

On Medicare’s new drug coverage, a typical person with Medicare (who presently has no prescription drug coverage), can save about 50 percent on prescription drug costs. Plans may have a monthly premium, deductible or co-payments, and may set a limit on what they will pay.

With an estimated 43 million Americans eligible for Part D, Mary Lou and her mother were not alone in facing an intimidating process.

And one local expert says there remain very few enrollment options for those who weren’t quite as lucky.

"There are really no options left for those who missed the enrollment period," says Ann Marie Grande, local Program Director for Maricopa County’s State Health Insurance Assistance Program (SHIP.)

"The only group that would be eligible to sign up at this point would be those who qualify for low-income subsidy programs. All others would have to wait for the next enrollment period, which begins on Nov. 15."

Coverage for this next enrollment period would begin Jan. 1, 2007.

But for those who did miss the May 15 deadline, all is not lost. Many local organizations and services are still available to those Medicare beneficiaries and their families and caregivers, who may still have unanswered questions.

For example, SHIP is a free health benefits counseling service that provides specialists trained in Medicare law and regulations, health insurance counseling and relevant insurance products.

Other useful resources include Maricopa County’s Area Agency on Aging, as well as Medicare’s website at www.medicare.gov. Spanish-only hotlines are available through the National Alliance for Hispanic Health to assist individuals with Medicare Part D questions.

For Mary Lou and her mother, such assistance proved to be useful.

"You really have to look at your individual situation and determine which plan meets your individual needs," Mary Lou says. "Don’t be afraid to ask questions or find someone that will ask them for you."