Choosing a Medicare Part D Plan: UNL Extension Offers Advice

By Sarah Van Dalsem

Medicare national health insurance has been available since 1965, but coverage for prescription drugs wasn't included until January 1, 2006. That's when Congress introduced Medicare Part D, which offers a variety of cost-saving prescription drug plans to Medicare beneficiaries.

What Medicare beneficiaries didn't get from Medicare Part D was an easy way to answer the question "which plan is best for me?" One way people can obtain help in answering that question is through University of Nebraska-Lincoln Extension, which offers one-on-one, personal assistance.

Mary Ann Holland, a University of Nebraska-Lincoln Extension educator, is one of four Nebraska educators who are specifically trained by the Senior Health Insurance Information Program (SHIIP) through the Nebraska Department of Insurance. Holland is the trained extension educator and is located in Weeping Water; Mary Loftis is in Tekamah; Jeanne Murray is in Alliance; and Carla Mahar is in Chappell and Oshkosh. These educators offer assistance year-round to Medicare beneficiaries, but additional extension educators statewide counsel beneficiaries during the open enrollment period in November and December. People who would like to take advantage of this assistance can call their local extension office any time and they'll be given the direct contact information for the nearest extension Medicare Part D advisor.

Holland said Medicare Part D consists of several drug plans, each offering insurance coverage for different prescription drugs. Holland's job is to help each beneficiary determine which plan covers the needed drugs and also works best with the beneficiary's budget. Plans change every year, so an annual advising session is usually necessary. Some people are paying a great deal of money every month for prescription drugs, she said, so carefully examining drug plans and choosing the right one may save some people hundreds of dollars every month.

However, extension educators will not tell a beneficiary which plan to choose. "Our job is to provide them the best educational information that we can, point out their options and help them see if there are any red flags in the drug plan that may cause them a problem," Holland said. "Affordability is one of the key things, as well as finding a drug plan that covers your drugs."

Mary Ann Holland

Medicare's website includes a drug plan finder, which helps beneficiaries determine which plans best suit individual needs. However, Holland said, many beneficiaries are much older than 65 and are not comfortable using computers. "So that's where someone to assist and educate is necessary," she said.

Holland asks each beneficiary to bring his or her Medicare card to the advising session. She enters into the computer the person's Medicare information, the prescriptions they take (including dosages) and the beneficiary's zip code; then the screen displays the drug plans available for that individual. Prices of drugs continue to change, she said, so premiums change, as well.

Holland says it's a bonus whenever an adult child, caregiver or spouse comes along to an advising session because the information can be complex and hard to understand. "They help fill in the gaps and remember what was said," Holland said.

"While University of Nebraska Extension certainly did not invent Medicare, the partnership between the Nebraska SHIIP and extension is a good one," Holland said. One of Medicare's needs is to get out in a rural area and meet with individuals, and that's what Social Security is looking for too, she said. The Social Security Administration is trying to identify people who qualify for available low-income subsidies. "Extension is the outreach that benefits them most, and that's already built into the extension system," Holland said.

Most Medicare beneficiaries are 65 or older and often have limited resources, she said, and choosing the right prescription drug plan can make a big difference in their monthly budgets. "A lot of people in this age group are folks who lived through the Depression, so they are in their upper 80s," she said. "They are proud people. They don't want to be handed money...they don't feel that's right." However, there is an income bracket above Medicaid called a "low income subsidy" and Holland said there is a dollar benefit for them - all they have to do is apply. Extension educators can help these people with the application process.

The extension Medicare educators in Nebraska held more than 100 enrollment events between mid-November and late December in 2009, assisting more than 1,800 Medicare beneficiaries and their families or caregivers. Between the fall of 2008 and the summer of 2009, extension educators counseled 2,295 clients and 938 either changed prescription drug plans or were enrolled in a plan, saving a total of nearly $646,000. "Those dollars, then, become available to be used in the beneficiary's local economy," Holland said.