BY Kelli Nakayama
ICHS
Kathy Lin spends upwards of four hours on the phone on most days. Switching from English to Cantonese and back, she makes calls and answers inquiries from mostly Chinese-speaking, Medicare-eligible senior citizens about Medicare’s new Prescription Drug Plan (PDP).
Lin is an Outreach Worker at International Community Health Services (ICHS), a nonprofit community clinic that serves primarily Asian and Pacific Islander patients in the International District and Holly Park neighborhoods.
By the end of the year, Lin says, “my goal is for all 1,200 of ICHS’ Medicare-eligible patients to be informed about the prescription drug plan.” The PDP will cover the cost of prescriptions for current and soon-to-be-enrolled Medicare clients beginning in January 2006.
In August of 2005, the federal Centers for Medicare and Medicaid Services (CMS) joined forces with community organizations like ICHS in order to inform traditionally hard-to-reach senior populations about the drug plan.
“CMS wanted to work with us because we are in the community and we have the language capacity to help these people,” says Lin, who is fluent in both Cantonese and Mandarin Chinese.
“We are here to provide the correct information to our patients and then tell them where the resources are and where they can get help,” she says.
Medicare is a government-funded health insurance program for people age 65 and over, people under age 65 with certain disabilities, and people of all ages with end-stage renal disease.
The new Medicare prescription drug program offers more than 40 stand-alone plans that Medicare recipients can choose from. Plans offer different drug formularies, depending on the level of coverage needed by the patient.
Applicants are asked to provide personal information, as well as a list of the medications they take. “It takes about 40 minutes to an hour to fill out,” Lin says.
The challenges of convincing Medicare recipients to enroll in the PDP are many, says Lin. “It is hard for many elderly to understand the plan because there are so many plans to choose from, depending on the needs of each individual,” she says.
“A lot of patients just call me and say, ‘can you help me?’ Or, ‘what should I do?’”
The enrollment period for the PDP began on Nov. 15, 2005 and will continue until May 15, 2006. Premium costs for the plans range from $7 to $65.
Medicare patients who do not enroll into a prescription drug plan by May 15, 2006 will have to wait until January 2007 to receive coverage. Additionally, patients who miss the deadline will have to pay higher premiums, which could increase by as much as 24 percent by January 2007.
To make matters more complicated, Lin says, patients with both Medicaid and Medicare coverage, also known as “dual eligibles” or “dual enrollees,” will be automatically enrolled into a pre-selected prescription drug plan.
The federal Department of Health and Human Services will send a letter, known as “the yellow letter,” to all dual enrollees to notify them of their pre-assigned plan. “It’s really important that they don’t throw this yellow letter away,” Lin says, “because the letter tells you what plan you’re assigned to.”
Lin urges Medicare recipients to find out if their pharmacies will accept Medicare’s prescription drug plan. “Talk to your pharmacy,” she says. “Before you select a plan, find out if you can continue to use your pharmacy with the new plan,” she urges.
Additionally, Lin encourages family members to assist Medicare enrollees to select a prescription drug plan. “Loved ones need to be involved to help their elderly and guide them through this process,” she says.
To sign up for a prescription drug plan or to get more information, Medicare enrollees can contact the Centers for Medicare and Medicaid Services (CMS) at 800-MEDICARE or the Statewide Health Insurance Benefits Advisors (SHIBA) at (800) 562-6900.
Medicare patients who would like information in languages other than English are encouraged to contact the National Asian Pacific Center on Aging (NAPCA), which offers assistance in Cantonese, Mandarin, Korean, and Vietnamese, at (800) 562-6900, or the Chinese Information and Service Center, which provides Chinese-language enrollment assistance, at (206) 624-5633.
Medicare recipients and their family members can also apply for the new prescription drug plan on the Medicare website at www.medicare.gov.
Established in 1973, International Community Health Services (ICHS) is a nonprofit community-based clinic committed to providing accessible, affordable and culturally relevant primary health care to Asian Pacific Islanders and other underserved populations in Seattle and throughout King County.