Article: Medicare Part D may opt spouses out of coverage
December 17, 2005
From Suddenly Senior
By DEVLIN BARRETT
The Associated Press
WASHINGTON -- The government's new drug benefit program is causing big headaches for the spouses of some patients who fear they will be dumped from their own health insurance next month due to a wrinkle in the program.
Katherine Kowalewski, 56, of Tonawanda in Upstate New York, worries that she is on the verge of losing the health care she receives through her husband's former employer because of a rule in the new drug program known as Medicare Part D.
She receives health insurance through his National Grid policy, but under the government's new health benefit plan, she and many other spouses may lose the company's coverage when the prescription drug benefit goes into effect next month.
Under government rules, those who fall into that triple-insurance category will be dropped automatically from their retiree benefit health plan in January if they don't tell the government they want to opt out of the new prescription drug benefit.
A spokesman for the federal agency administering the program says they don't know how many spouses could be affected by the rule, but notes that companies have an obligation to alert their retirees of the potential loss of coverage due to Medicare Part D.
"It's a mess," Kowalewski said. "I'm being told different things, and nobody can confirm or deny what will happen to us.
"I think the Medicare Part D that was created may be very good for a lot of seniors, but I think they totally neglected to think of the younger people in the community, particularly the people with spouses, Alzheimer's, multiple sclerosis and Lou Gehrig's disease."
Kowalewski, a bookkeeper at a Buffalo company, takes medication for high blood pressure and a thyroid condition and worries that even a temporary loss in coverage could seriously hurt her health.
Medicare spokesman Peter Ashkenaz said companies are notifying retirees by mail that if they don't opt out of Part D, they will lose coverage under the company plan. In the case of the Kowalewskis, that would mean the spouse also loses company coverage.
"The people who don't take any action at all could actually find themselves just covered by Medicare or Medicaid ... so it's real important that they look at the information they received in the mail," Ashkenaz said.
Ashkenaz urged those with questions to call the Medicare hotline at (800) 422-7800.
Sen. Charles Schumer, D-N.Y., criticized federal officials for making the options -- and potential dangers of losing coverage -- hard to understand.
"This is just a glaring example of what a mess this prescription drug program is. My own parents called me up and they said, 'What do we do?"' said Schumer, who is calling for the whole plan to be scrapped.
"For all the thousands of bureaucrats that they have, they did not think this through clearly enough," Schumer said.
Schumer said there are 124 residents alone in Cattaraugus County nursing homes who stand to lose their retiree health plans if they don't opt out of the government's plan by the end of the month.
From Suddenly Senior
By DEVLIN BARRETT
The Associated Press
WASHINGTON -- The government's new drug benefit program is causing big headaches for the spouses of some patients who fear they will be dumped from their own health insurance next month due to a wrinkle in the program.
Katherine Kowalewski, 56, of Tonawanda in Upstate New York, worries that she is on the verge of losing the health care she receives through her husband's former employer because of a rule in the new drug program known as Medicare Part D.
She receives health insurance through his National Grid policy, but under the government's new health benefit plan, she and many other spouses may lose the company's coverage when the prescription drug benefit goes into effect next month.
Under government rules, those who fall into that triple-insurance category will be dropped automatically from their retiree benefit health plan in January if they don't tell the government they want to opt out of the new prescription drug benefit.
A spokesman for the federal agency administering the program says they don't know how many spouses could be affected by the rule, but notes that companies have an obligation to alert their retirees of the potential loss of coverage due to Medicare Part D.
"It's a mess," Kowalewski said. "I'm being told different things, and nobody can confirm or deny what will happen to us.
"I think the Medicare Part D that was created may be very good for a lot of seniors, but I think they totally neglected to think of the younger people in the community, particularly the people with spouses, Alzheimer's, multiple sclerosis and Lou Gehrig's disease."
Kowalewski, a bookkeeper at a Buffalo company, takes medication for high blood pressure and a thyroid condition and worries that even a temporary loss in coverage could seriously hurt her health.
Medicare spokesman Peter Ashkenaz said companies are notifying retirees by mail that if they don't opt out of Part D, they will lose coverage under the company plan. In the case of the Kowalewskis, that would mean the spouse also loses company coverage.
"The people who don't take any action at all could actually find themselves just covered by Medicare or Medicaid ... so it's real important that they look at the information they received in the mail," Ashkenaz said.
Ashkenaz urged those with questions to call the Medicare hotline at (800) 422-7800.
Sen. Charles Schumer, D-N.Y., criticized federal officials for making the options -- and potential dangers of losing coverage -- hard to understand.
"This is just a glaring example of what a mess this prescription drug program is. My own parents called me up and they said, 'What do we do?"' said Schumer, who is calling for the whole plan to be scrapped.
"For all the thousands of bureaucrats that they have, they did not think this through clearly enough," Schumer said.
Schumer said there are 124 residents alone in Cattaraugus County nursing homes who stand to lose their retiree health plans if they don't opt out of the government's plan by the end of the month.
posted by Kathie Bracy at 1:29 PM
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