- The Washington Times - Thursday, May 11, 2006

Mark Fischer arrived at the downtown office of the Legal Aid Society of D.C. toting parcels of paperwork and books that made a loud thud when they landed on the conference room table.

One of those books was a thick federal guide: “Medicare & You; 2006; This year it’s different.” What an understatement.

“I’ve dealt with the government for years, I worked for the government for 30 years, and I have a master’s degree, and still it’s a huge challenge … to sort through pages and pages of stuff,” said Mr. Fischer, 56, who has mental disabilities.

“I’m not stupid, and I am as frustrated as can be, so having somebody come in and help me with this is important,” he said. Mr. Fischer is among millions of people, mostly senior citizens — more than 310,000 in the D.C. area — who must figure out by midnight Monday which of the numerous prescription drug plans is best for their medicines under the new Medicare Prescription Plan D guidelines.

According to lawyers at the Legal Aid Society of D.C., some 16,000 low-income seniors, previously in drug prescription plans paid for by D.C. Medicaid, are eligible to enroll in one of 48 new drug plans paid for by Medicare Part D.

Groups such as Legal Aid have been working feverishly to help these individuals get the coverage they need. Similar last-minute efforts are taking place in Maryland and Virginia.

“We’ve had a large push to capture those who haven’t been enrolled,” said Sarah Lichtman Spector, the Legal Aid staff attorney representing Mr. Fischer and others. Legal Aid is holding a special information session tomorrow in Anacostia and offering free advice to individuals in their offices tomorrow and Monday.

Still, this critical deadline should be extended by Congress.

“It would be extremely helpful to have the deadline extended,” Ms. Spector said. “People with Medicare should not be faced with a financial penalty because they have not enrolled by Monday. The program is confusing and complex.

“There are multiple reasons that not everyone will be enrolled by Monday and that includes outreach, which has still been lacking in many communities. Medicare beneficiaries have various limitations, including literacy issues and limited cognitive or physical abilities. Specifically, financially penalizing low-income clients is outrageous.”

On Wednesday, President Bush completed a three-day tour in Florida to tout the benefits of the new options. The change is a result of the Medicare Modernization Act, passed by Congress in 2003, that created the prescription drug benefit known as Part D. Not all seniors are unhappy with the change. Some are saving money.

If this prescription plan is such a benefit, then why not extend the deadline for a few more months to allow more seniors, who are having difficulty signing up, to participate? Seniors who do not make a decision by Monday will receive stiff penalties unless the meet some of the low-income criteria, Ms. Spector said.

On the savings question, Ms. Spector said, “I hate to say this, but it depends. People who had Medicaid before and were only paying $1 per prescription for every med are paying much more, sometimes as much as three to four times more than prior to [Dec. 31]. People who never had any coverage at all, especially those who are low-income and can get the subsidy, are able to save lots.”

Since the Jan. 1 Medicare Part D conversion date, Legal Aid has assisted more than 300 D.C. residents.

As Mr. Fischer leans across the table, fanning out his papers, his anxious conversation is peppered with all sorts of acronyms he obviously has learned trying to get the proper coverage.

“I was able to dig until I found a kindred spirit at the [D.C.] mental health office who helped me get through two refills,” he said. His income is slightly above the poverty limit, which means he falls through the bureaucratic cracks.

“I’m fortunate that I’ve been successful. I think about people who don’t have the wherewithal; that’s troubling and truly scary to me,” Mr. Fischer said.

Legal Aid lawyers successfully lobbied the city to get an additional $3 million funding as a stopgap measure for the program to help the indigent.

“The federal [income] guidelines are way out of whack,” Mr. Fischer added.

“It is critical that the eligible residents know about the date and that there is help for them in navigating through the system so they don’t suffer the consequences of not getting the medication they need and depend on,” Ms. Spector said.

Mr. Fischer agreed. “I’d really struggle without the extra help and without the extra subsidy. People don’t know how to work the system.”

That’s why the deadline must be extended.

Legal Aid representatives will be hosting a clinic from 10 a.m. to 1 p.m. tomorrow at the Anacostia Health Center, 1328 W St. SE. Also low-income residents needing help can call Legal Aid at 202/628-1161. The George Washington University Health Insurance Counseling Project at 202/739-0668 is another great resource.

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