Still More Problems with the Medicare Drug Plan

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Whether they are already enrolled or still considering signing up for the new Medicare prescription drug benefit, senior citizens have to be careful when they do their comparison shopping among the various private insurance plans that administer the program. That, at least, is the message conveyed in a new Government Accountability Office report that warns of continuing problems with the quality of information provided by the telephone customer support at the various plans — and which is sure to stoke more partisan fire over the controversial program.

GAO investigators last March made 900 phone calls to the call centers for the 10 largest private insurance plans handling the drug program and found that on two-thirds of the calls they were given incorrect or incomplete answers to questions. In particular, in 70% of the cases when service reps were asked a question like "My mother takes the following drugs... which of your plans would cost her the least amount annually?" they provided inaccurate or incomplete responses.

Medicare officials are furious with the report. Mark McClellan, administrator of the Centers for Medicare and Medicaid Services, fired off an angry memo to GAO after he read it, accusing the agency of using "inaccurate, incomplete and subjective methods" to reach its conclusions. McClellan complains that the congressional watchdog agency asked trick questions in some cases, which a call center employee couldn't be expected to answer. GAO stands by its questions and its conclusions.

Meanwhile congressional Democrats, who've long complained that the prescription drug benefit is a disaster, were quick to pounce on these findings as more evidence of flaws in the program. "The poor quality of information is inexcusable," says Rep. Henry Waxman, senior Democrat on the House Government Reform Committee. "Seniors with basic questions about Medicare drug benefits are being left in the dark."

That may be too harsh, but certainly the report doesn't bode well for future enrollees or just those looking to change their plans. Though seniors had until May 15 to enroll without penalty in a Medicare drug plan, which proved to be a daunting task for many of the 16.4 million who did, millions of others have yet to join the program — and many low-income seniors can still do so without a penalty. From Nov. 15 to Dec. 31, the elderly who are already signed up can switch plans during the open enrollment period. Each state has 40 to 50 different plans to choose from, and each insurance company is required to set up call centers to answer questions about the different plans it offers to help seniors pick the right one for their drug needs. But the lesson seniors should draw from the GAO report is that, whether signing up for the benefit the first time or renewing it, you need to study the plan carefully yourself.