WASHINGTON — Nearly 1 million poor and frail California seniors who will be transferred automatically into the Medicare prescription program Jan. 1 can get transitional help from the state if private insurers under the new plan do not cover their particular medications.
But no one has notified those eligible of the state's policy -- which provides up to a 100-day supply of medicines they are currently taking, including expensive name brands -- and they only have until Dec. 31 to request and receive the medication.
"How can this be a safety net if the beneficiaries haven't been notified?" said Betty Dahlquist, executive director of the California Assn. of Social Rehabilitation Agencies, a Bay Area group involved in mental health issues.
"If I was completely cynical, I'd think this was about budget-balancing," she said.
The notification delay is another snarl in what is shaping up to be a difficult launch for the Medicare prescription drug program. The most significant expansion of Medicare in 40 years is marked by complexity, frustrating beneficiaries and their families as well as government officials and social-service providers who are trying to help.
California officials say they are planning a mass mailing between Wednesday and Dec. 21 to let beneficiaries know that help is available, though the officials acknowledge it is late in the game.
California's deputy director of medical care services, Stan Rosenstein, dismissed Dahlquist's suggestion that the state might be trying to keep quiet about the 100-day drug benefit as a way of saving money.
"It is a cost that we decided to pay and we will pay it," Rosenstein said. "Gov. [Arnold] Schwarzenegger has put in over $100 million to pay for services to make this transition easier. He is invested in this."
The affected seniors, as well as a considerable number of younger disabled people, are covered by both Medicare and Medi-Cal, a federal-state program that serves the poor and disabled. The federal government has decided to automatically switch these so-called dual eligibles, whose prescriptions are now paid for by Medi-Cal, to the Medicare drug system.
That worries some advocates, because Medi-Cal's prescription coverage is much more generous than that of many private plans in the new Medicare benefit. Advocates fear that people who depend on expensive drugs will lose access to some medications and wind up in emergency rooms.
