Staff from Monroe County Area Agency on Aging have been presenting programs about Medicare D and providing individual assistance for several months.

Sharon Miller, the agency's ombudsman/care manager, said, "It's brought an extreme amount of calls into our office. It's such a confusing program that people don't understand it."

Miller and other staff and volunteers have been meeting with seniors by appointment to help them choose a plan. On the medicare.org Web site, they enter Medicare information and prescription information for clients. With this information, the site will automatically find plans that best suit that person.

Miller cannot tell anyone what plan to enroll in, however. Each person must make his or her own decision. Once they have the information, some people enroll right away, but others take a print-out of their plan options to decide at a later date.

Miller said she advises people to call the insurance company before enrolling just to verify that their prescriptions will be covered and that the premiums, deductible and costs are correct. They also need to make sure their pharmacy will cover that plan.

A positive outcome of so many people coming to the Agency on Aging office for help has been identifying people who were not aware they are eligible for PACE or PACENET, the Pharmaceutical Assistance Contract for the Elderly in Pennsylvania.

Representatives from the Centers for Medicare and Medicaid Services, Region III, based in Philadelphia, have been making the rounds to help people sign up for Medicare D.

In early March, they arrived at Stroud Mall with the Medicare Prescription Drug Coverage Mobile Enrollment Center, a bus equipped with satellite connection to the Internet.

"There's a lot of need for face-to-face information," said Lorraine Ryan, a CMS representative. "They want that assurance they're doing the right thing."

Seven CMS counselors set up in the food court that day to handle the crowd, entering Medicare and prescription drug information into laptop computers and providing unbiased help.

After waiting more than an hour, William Zacharias of East Stroudsburg got to sit down with a counselor to get help choosing a plan for his mother, Myrtilla Zacharias, 88, who lives in a nursing home.

"It's very complicated. There are so many choices," Zacharias said. "If you're dealing with a certain pharmacy, you have to make sure the pharmacy accepts the plan."

"You have to look at cost, coverage and convenience," Ryan said. "How much are you now spending on medications? What drugs do you take, the dose and the frequency? Does your pharmacy participate in that plan?"

As the initial enrollment approaches the May 15 deadline, people are signing up in greater numbers. The U.S. Department of Health and Human Services reported that as of March 18, more than 27 million Americans had enrolled in some form of the Mediare Prescription Drug Plan.

The arrival of Medicare D on Jan. 1 increased the work load, reduced the amount of money pharmacists receive for prescriptions and restricted what pharmacies a customer can use.

Tom Morrissey, pharmacy manager at Kresge-Lebar in Stroudsburg, said Medicare D was responsible for "the most miserable two months of my life as a pharmacist."

Morrissey, who began working in the pharmacy business in 1962, said, "Medicare D made some people wonder if it's worth staying in business or not."

Customers on Medicaid and Medicare created the most confusion. When CMS randomly assigned dual-eligible people to a plan, many people were not notified about that plan before Jan. 1.

"People thought their Access card would still work, but it didn't. They didn't know what plan they were on, and neither did we," Morrissey said.

Some people discovered that the medications they were taking were not covered by the plan they were assigned. Some customers were allowed to continue taking their medication temporarily.

"As we're approaching the end of the third month, some people are being told now it's time to get something comparable," Morrissey said. "There are still some problems with the program."

In addition to entering all new insurance information for every customer with a new plan, pharmacists are finding the new insurance plans pay significantly less than what the pharmacy considers a fair price, Morrissey said. "How can you expect these pharmacies to stay in business? Independent pharmacies are really struggling."

Morrissey said he has lost customers who have signed up for Humana, which restricts pharmacies people are allowed to use. "One customer has been dealing with us for more than 40 years. After signing up with Humana, she can't use our pharmacy."

While acknowledging that Medicare created the prescription benefit to help people save money, Morrissey said that Pennsylvania already has PACE and PACENET, "which are better than many of these programs."

There are three different tiers of drugs: generic drugs, drugs that need prior authorization and drugs that are excluded. To keep patients on the medications they need, doctors' offices have been overwhelmed by the task of authorizing prescriptions.

"Since this started, we have had nothing but increased paperwork," said Dr. Natale Falanga, an East Stroudsburg physician. "Suddenly carriers need prior authorization. These are medications people have been on for years."

Dr. Douglas A. Degler, an East Stroudsburg internist, said that while Medicare D has become a burden on his staff, he views the plan as a positive thing for his patients. "A lot of these people are on fixed incomes and it helps them out."

"No two patients are alike in their needs, and no one can predict what will happen next year," Degler said. "People aren't getting healthier as they get older. A lot of guesswork goes into choosing the right plan."

People on limited income with limited resources may qualify for extra help paying prescription drugs. To apply, people earning less than $14,355 and married couples earning less than $19,245 may call the Social Security Administration at 1-800-772-1213 to make an appointment. Visit www.socialsecurity.gov. • The Monroe County Area Agency on Aging APPRISE Program is holding comparison and enrollment sessions on the Medicare Prescription Drug Plans. Call 570 420-3735 or 1-800-498-0330 to schedule an appointment. Anyone enrolled in Medicare A and B can call the agency for help in selecting a plan.

• Visit medicare.gov. On this Web site, people can enter their Medicare information and prescription information to obtain a list of plans that cover those drugs. People can compare plans and chose the one that meets their needs.

This is cache, read story here