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Seniors Struggling With New Drug-Benefit Plan

Seniors Struggling With New Drug-Benefit Plan

UCSD Professor to Receive Medical Thoracic Society Award

Health Care

by Marion Webb, Senior Staff Writer

Joy Parker’s office has been inundated with inquiries from seniors who are struggling to pay for their medicine since Medicare HMOs stopped providing full drug benefits.

Parker, who is the program manager for the Health Insurance Counseling and Advocacy Program (HICAP) for San Diego and Imperial counties, said the number of phone calls has risen dramatically since October when Medicare HMOs first announced they would reduce or cut prescription drug benefits.

The policy change, which took effect in January, has affected thousands of seniors in San Diego.

“Some of them are saying that they are taking brand-name drugs and (that) they aren’t being offered any more (by their Medicare HMOs),” Parker said. “We can give them information on other plans and pharmaceutical companies (that offer drugs at reduced prices).”

Under the new policy, Blue Cross’ Senior Secure and Health Net’s Seniority Plus scrapped brand-name drug benefits altogether but still cover generic drugs, she said.

Kaiser Permanente’s Senior Advantage and Health Net’s Seniority Plus still cover some brand-name drugs and many generics, but annual coverage for all drugs is capped at $2,000, she said.

Anything beyond that amount comes out of seniors’ own pocketbooks.

Some Medicare HMOs also implemented significantly higher co-payments for treatments like cancer therapies and oxygen and equipment aids, such as wheelchairs and beds, which worsens the financial situation for many seniors, a HICAP employee who didn’t want to be named.

HMOs in turn said they had no other choice, given that federal reimbursement rates have not kept pace with rising health care and prescription drug costs.

Parker said seniors may be able to reduce their costs by “shopping around” for better deals. That includes comparing benefits offered by Medicare HMO plans, price shopping at retail pharmacies and checking Web sites of major drugmakers to learn about their plans for eligibility on discounted drug sales.

Parker said it’s quite common for major drug makers to offer special deals on drugs.

This month, New York-based Pfizer Inc., for instance, introduced lower rates on a 30-day drug supply for seniors with an annual income below $18,000 and for couples with a yearly income below $24,000 and have no other prescription drug coverage, Parker said.

California also offers seniors a deal through its California Discount Prescription Drug Program. Under this plan Medicare beneficiaries can buy drugs at lower Medi-Cal rates at participating pharmacies.

For information on medicines, go to (www.pharma.org).

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Award: Kudos to UCSD Professor John West, who will receive the Edward Livingston Trudeau Medal, the highest award of the Medical Thoracic Society for his contributions to the control, prevention and treatment of lung disease.

Send health care news to

mwebb@sdbj.com.


2001 Saw Cutback in Overall Energy Use

Californians saved money and reduced the chance of blackouts by cutting energy use by 6.7 percent and summer peak use by 10 percent in 2001.

Gov. Gray Davis said he was proud of the accomplishment, since energy conservation made a “crucial difference” in 2001.

Davis cited a newly released study, Summer 2001 Conservation Report. Thanks to consumer rebates, a media campaign, improved building and appliance energy efficiency standards and other initiatives, Californians more than met the goal of reduced demand by 5,000 megawatts, he said.

The state reduced its energy use by 5,570 megawatts during the summer; by October, that figure rose to more than 6,300, Davis said.

The report also debunked theories that these results were because the state economy was in a recession or because the weather was cooler than in previous summers. Instead, the state saw a general increase in economic activity, Davis said.

As for the weather, 2001 was the 25th hottest summer in the last 107 years, he said.

The report also has suggestions to increase future conservation efforts. These include incentive programs, educational efforts, and encouraging neighboring states to enact similar programs, Davis said.

The report is at the California Energy Commission Web site, (www.energy.ca. gov).


Unemployment Rises Locally

San Diego’s unemployment increased to 3.9 percent in January, but was still below the state’s rate of 6.7 percent and the national rate of 6.3 percent.

Last month’s unemployment was up from December when those receiving unemployment benefits made up 3.3 percent of the total working population of the county, according to the state’s Employment Development Department.

Nonfarm jobs last month declined by 11,000, bringing the total number of nonfarm jobs to 1,228,300 in the county. Most of the lost jobs were seasonal, with the retail industry accounting for 5,100 of the total.

Jobs in the government sector declined by 1,400.

Compared to January 2001, the county gained 28,900 jobs or 2.4 percent. The services sector was the largest contributor to that number by adding 12,000 jobs over the year. Government expanded by 8,500 jobs, and retail trade by 5,400.

The biggest decline came from the manufacturing industry, which lost 1,400 jobs over the year. Some 800 jobs were lost in the transportation and public utilities area.

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