With Medicare Part D – just do it

If you are on Medicare, know someone on Medicare, or might some day be on Medicare, this column is for you.

When Eliza Doolittle of the wonderful movie “My Fair Lady” shouted the immortal words “Come on, Dover, lift your bloomin’ arse!” to the horse on whom she had placed a bet, she might as well have been talking to senior citizens hesitating to sign up for the new Medicare prescription drug benefit because the thing is so darn confusing. I am with Eliza on this one.

Yes, the thing looks as if it was designed by a bunch of chimps high on cocaine. Yes, Pepto-Bismal looks clear by comparison, and yes, if you refuse you will be in good company because millions of American senior citizens have said the whole thing is so confusing they are not going to sign up. As a doctor and a big mouth, here is my advice for most of you on Medicare; figure it out and sign up. The results will be worth it to most Medicare recipients.

The new Medicare benefit is called Medicare Part D (remember D for Drugs, or Darn Dumb Design), and it starts in January 2006. You have to figure it out and sign up to get it, no matter how cute you are, how far over 65 you may be. You may have worked your whole life for your Medicare benefits, but you are going to have to work a little more for this one.

The basic details of the Medicare prescription drug benefit are so confusing you may want to get them tattooed onto your leg. First you have to figure out if you should sign up, because if you already have a prescription drug plan provided to you as a retiree of some company, it might not make sense for you to cancel that retiree coverage and sign up for Medicare’s drug plan.

If you do decide to sign up for Medicare Part D, then you have to pick a drug insurance plan that will be offered to you by a drug insurance company. Different plans will have different drugs and different premiums, so you must choose with some care. In some states Medicare recipients may have to sift through more than 40 plans to find the one right for them.

A lot of things should not be done alone, and struggling through the Medicare Part D maze is one of them. My bet is even retired rocket scientists are going to get help with this, and there is a lot of help out there. You can get it by calling Medicare at 1-800-Medicare (800-633-2273), or by going to Medicare’s Web site at www.medicare.gov. If you don’t have access to the Web, your library probably does and so does your 12-year-old granddaughter. Many local community groups, state government agencies and others are willing to assist you through the process.

If there is some smartee-pants in your family tell them all you want for Christmas is for them to slog with you through your Medicare Part D benefit information, and help you figure out what to do. It may also be useful to sacrifice some chickens, burn incense, do the hokey-pokey and turn yourself around.

My bet is your physician will not be of much assistance, although you can ask if you want to see what a smart deer in a white coat looks like caught in the headlights. Most doctors do know, however, that most of their patients should sign up for Medicare Part D. What you do with your physician is check before you sign up for a plan that would change a bunch of your medicines. Failure to do so may cause your physician to refer you for brain surgery. And if your doc is 65 or over, he or she could probably use your help signing up for their Part D benefit.

It may be tempting to those lucky enough not to be on any prescription medications to take a pass on Medicare Part D and not sign up. You should think that one through, too, and for at least two good reasons.

First, most of us are just one unexpected ailment away from needing to take a $3 pill for the rest of our lives. If you currently spend just $100 on prescription drugs each month, signing up could save you about $300 a year. That may not seem like much, but if 5,000 of you reading this column decide to sign up after reading it, and send me just 10 percent of what you save, I will really appreciate it – from my yacht in Jamaica each winter. If you spend $200 a month, signing up could save you about $1,200 a year.

Second, if you sign up after May 15, 2006, your monthly premium for Medicare Part D will be higher than if you sign up before that.

The work of signing up for the Medicare prescription drug benefit is a bit like walking out some winter morning to 16 inches of new snow in your driveway. You just have to suck it up, put the plow down, or get the blower cranked, or get the shovel out, and “Get ‘er done.” It will be worth the work, and Miss Doolittle would be so proud if you made Dover look like a slacker by comparison.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region.