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Medicare Patients Can Find Drug-Plan Bargains - If They Shop

Medicare open enrollment season is around the corner, and lots of bargain plans are available to beneficiaries who shop around. But will they?

Two-thirds of drug-plan enrollees say they won't bother, according to a survey released Wednesday by Medicare Today, a consortium of consumer and professional health groups. They see no reason to -- 90 percent report that they're satisfied with their plan.

But even if they're not satisfied, seniors often don't tackle the job of comparison-shopping. Experts call this "the lock-in effect," and it can keep beneficiaries from taking the pills they've been prescribed.

Dave Tachney, 68, is well aware that the cost of his Medicare prescription drug plan is going up and he's not happy about it.

"There are drugs I can't take now because I can't afford it," Tachney says.

He's not the only one who will be digging deeper into his pockets this year. Most of the best-selling Medicare prescription drug plans are going up in 2013, some by quite a lot.

At the same time, new low-cost plans are entering the market to attract new enrollees. Tachney probably could find a better plan, if he would only look.

Leigh Purvis with the AARP's Public Policy Institute says it's common for Medicare providers to draw plan members in with low prices -- and then raise them.

"What plans do know is that once they have an enrollee in their plan, chances are they aren't going to move which makes it possible for them to increase premiums and cost sharing the way that they have," Purvis says.

Joe Baker, president of the Medicare Rights Center,calls it the "lock-in effect."

"The lock-in effect is basically something that has been studied and shown that once someone chooses a part D prescription drug plan, that they stay with that plan even after premiums go up, or benefits might change to their detriment," Bakers says.

Purvis says there are several reasons why an enrollee might stick with their plan even if it's not the best one for them. There are just so many to choose from -- almost three dozen in Florida.

"In a lot of cases they have more than 30 plans to sort through in their area," she says, "there are a lot of different things to look at: premiums, cost sharing, deductibles."

That's something that can make it frustrating for plan members when they try to shop around. Ask Tachney.

"It's not doing much good. Stupid damn things!" he says.

Mary Grealy, who spoke to reporters about the Medicare Today survey, says Tachney's not alone in his frustration.

"We asked seniors were they likely to shop around. One in three said the plan information was too difficult for them to compare," she says. 

She's asking for help.

"We really encourage the sons and daughters and grandchildren to help them find a plan that works better for them."

This market competition has kept the average price per plan -- around $30 a month -- stable for the past three years, according to a report from the Galen Institute.

In fact, the 90-percent satisfaction rate shows that the prescription-drug benefit despite increasing costs, senior's satisfaction with their plans is surprisingly high.

A survey commissioned by Medicare Today, a consortium of non-profit medical and consumer groups, found that nine out of 10 plan members are happy with what they have.

Grealy says it's one of the few issues Republicans and Democrats seem to agree on.

"They agree on their support for the Medicare Part D program," she says.

That's why Joe Baker with the Medicare Rights Center works with seniors to find them the best deal -- whether they think they need it or not.

"We want to look for cheaper plans but we also want to look for plans that also provide them coverage for their drugs," he says, "because if the plans are cheap but don't pay for the drugs, they are going to be expensive overall because you are going to be paying out of pocket."

He says it's just one of many things to consider when shopping around this open enrollment season.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.After serving two years as a Peace Corps volunteer in Colombia, Gentry worked for a number of newspapers including The Wall Street Journal, St. Petersburg Times (now Tampa Bay Times), the Tampa Tribune and Orlando Sentinel. She was a Kaiser Foundation Media Fellow in 1994-95 and earned an Master's in Public Administration at Harvard’s Kennedy School of Government in 1996. She directed a journalism fellowship program at the Centers for Disease Control and Prevention for four years.Gentry created Health News Florida, an independent non-profit health journalism publication, in 2006, and served as editor until September, 2014, when she became a special correspondent. She and Health News Florida joined WUSF in 2012.
Sarah Pusateri is a former multimedia health policy reporter for Health News Florida, a project of WUSF. The Buffalo New York native most recently worked as a health reporter for Healthystate.org, a two year grant-funded project at WUSF. There, she co-produced an Emmy Award winning documentary called Uniform Betrayal: Rape in the Military.