WASHINGTON, Jan. 31 (UPI) -- More than 3 million low-income seniors still lack Medicare drug coverage, and hurdles to their enrollment need to be removed, experts testified Wednesday before the Senate Special Committee on Aging.
In addition, more than 400,000 seniors who automatically qualified for Medicare Part D's low-income subsidy in 2006 have been disenrolled and have yet to reapply, though they may still be eligible.
"You can have a great program ... but unless (we reach) those who don't know about these programs, we're making a big mistake," said Sen. Robert Casey, D-Pa.
Obscured by the debate raging over whether Medicare should negotiate lower drug prices, Medicare, state governments and senior advocates are struggling to reach the seniors who need drug coverage most: those with incomes limited enough to qualify for the subsidy.
With the subsidy, seniors with incomes below 150 percent of the federal poverty line are able to access drug plans with little or no out-of-pocket costs and coverage through the gap known as the "doughnut hole."
But many eligible seniors have been difficult and expensive to reach. The job could be made easier by streamlining the application process, eliminating asset restrictions and giving more funding to community resources that help seniors enroll.
The paperwork involved in registering for the program is complicated and poorly coordinated with other federal programs for low-income seniors, said Howard Bedlin, president for public policy and advocacy at the Access to Benefits Coalition.
There should be a one-stop online application that can be submitted electronically that checks eligibility for multiple programs like food stamps, Medicaid and Medicare drug coverage, he said.
Language on the application form warning that they face prison time if they include false information -- even mistakenly -- should also be eliminated to make the process less intimidating to seniors, Bedlin said.
"We keep looking for needles in a haystack when a lot of these people are the same individuals," Casey agreed. "We need to pull together all the different piles of needles that have already been found."
Using tax information from the Internal Revenue Service to identify eligible individuals could make them easier and cheaper to reach, said Beatrice Disman, chairwoman of the Social Security Administration Medicare Planning Task Force.
In an age where marketers know which households "like pets and eat ice cream," such information on which beneficiaries qualify for extra help should be accessed also, said Sen. Blanche Lincoln, D-Ark.
Income and asset reporting requirements should also be revisited, panelists said. Currently, retirement savings over $23,410 per couple can disqualify beneficiaries from receiving the subsidy. Seniors are also asked to estimate the value of help they get for meals or other household expenses and the cash value of their life-insurance policies.
Given the current complicated process, more help is needed for the State Health Insurance Assistance Program (SHIP), said Ellen Leitzer, executive director of the Health Assistance Partnership.
There are now 1,400 community-based SHIP programs with 12,000 staff members and volunteers that sit down with seniors and help them enroll in Medicare programs.
But the program is underfunded at $31 million, and funding does not appear set to increase for 2007, Leitzer said.
Also, staff at the 1-800-MEDICARE hotline, which is operated by a private company and has a far larger budget, routinely refer beneficiaries with difficult questions to local SHIPs, she said. The benefit is "so complex and arcane that it has overwhelmed the system ... created to implement the program."
"Those programs cannot and do not properly function."
However, efforts are being made at the federal level to make the subsidy more accessible, panelists said.
The Social Security Administration hired a vendor to contact 9.1 million people about the subsidy, and follow-up notices and phone calls were sent by the administration directly, Disman said.
"We will not rest until we have reached every eligible beneficiary who wants to apply for the (low-income subsidy)," testified Larry Kocot, senior adviser to the Centers for Medicare & Medicaid administrator. "We realize this is the hardest population to reach ... but we will continue trying."
Congress may also intervene to simplify the application process, possibly as part of other changes to Medicare Part D, Committee Chairman Herb Kohl, D-Wis., told United Press International. "We're working with a lot of people, and we're really going to push it."
