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Pharmacist Sees Medicare Confusion Up Close


Back when the new Medicare program was first introduced in January, we called a pharmacist in Iowa to see how things were going. We decided to ring his number again for a status report as the deadline nears. His name is Alan Julius and he's the pharmacist at Valley Pharmacy in Cherokee, Iowa. He joins us now. Good to talk to you Mr. Julius.

ALAN JULIUS: Well nice to talk to you again.

NORRIS: Well in your estimation why has it been so difficult to get people to sign up for the plan?

JULIUS: Well at this point, and the people that are enrolling now have been on the fence, and not sure whether they should sign up. Many of these people just simply don't take a lot of medications, and so they're reluctant and waiting to start. Although I'm finding as people come in, that many of them should've started in January and they would've received much more benefit. And that signing up this late in the year by the time that they've met their deductible and they'll be getting some benefit from the program, it will be at the end of the year, and it will start over again.

NORRIS: So you're saying that it sort of falls into various categories. If someone currently needs to take a prescription, they're more likely to jump into the program. Those who don't presently need drugs, they're more likely to be holdouts?

JULIUS: That's right.

NORRIS: And as they weigh this decision are they coming in and seeking your advice talking to you about this? And, if so, what are you hearing?

JULIUS: Well yes they are. They're as confused now as the other patients were at the beginning of the year. And so they just want my advice on which plan they should choose. Obviously I can't pick a plan for them, but most of the people here do not have access to the Internet or simply don't know how to use the Internet. And so we have recently been enrolling a lot of people on line for them. We'll go to the medicare.gov website and go to the plan finder and help pick a plan that's best for them. And then enroll them right there.

NORRIS: Now are you equipped to dispense that kind of advice? Is that something you're even supposed to be doing?

JULIUS: Well no we're not supposed to pick plans for them. And, but we can assist them like I say online. We can assist them and with the plan finder, it will rank the various plans, and so they can choose. The final choice is theirs.

NORRIS: I know that people make these decisions based on very personal factors. But if you were to speak in very general terms, what are the benefits and what are the costs involved in joining the program, the decision whether or not to join the program?

JULIUS: Well again it depends on their utilization. How much they're spending on a monthly basis in medications. It can be a considerable benefit if they are spending over $1,000 a year in medications.

NORRIS: And can you give us an example of what kind of patient would be spending that much money on medications?

JULIUS: Well, the average Medicare recipient spends about $2,900 a year in medications. For that person, they're going to save about half. For those people that are left, say, maybe only $800 a year, it's really questionable in terms of a benefit. And so this is different than what Medicare has been in Part A and B where it's a true benefit. This they really have to look as an insurance, okay. That maybe sometime in the future if they're on more expensive medications, then they will be covered. They will have some coverage. Then they will be enrolled in the system, and they won't be penalized.

NORRIS: It's been almost six months since the program was rolled out. From your perspective standing behind the counter with your white coat on, is it working?


NORRIS: Didn't mean to put you on the spot.


NORRIS: But you're out there where, as they say, the rubber hits the road.

JULIUS: Yeah well we can't go back but I'd, it's not working very well.

NORRIS: Well, Alan Julius, it's been good talking to you again. Thanks so much for your time.

JULIUS: Well sure. Thank you for calling.

NORRIS: Alan Julius is a pharmacist at Valley Pharmacy in Cherokee, Iowa. Transcript provided by NPR, Copyright NPR.