WASHINGTON – The government will begin sending out millions of applications this week to poor Medicare (search) beneficiaries who may qualify for extra help next year paying for prescription drugs.
But the neediest and most vulnerable senior citizens may be scared away by the six-page application that requires details of their finances and warns that anyone who gives false information could go to prison, advocacy groups say.
"Realistically, if we hit 50 percent enrollment we'll be slapping ourselves on the back," said Robert M. Hayes, president of the Medicare Rights Center, an organization that helps older adults and people with disabilities access health care.
Under the prescription drug benefit that begins Jan. 1, low-income Medicare beneficiaries get an additional subsidy to help them pay for their deductible, monthly premiums and other expenses. Officials estimate the low-income subsidy will average $2,300 per recipient.
Mark McClellan, administrator for the Centers for Medicare and Medicaid Services, acknowledges the task of enrolling people will be difficult, but he believes the government will have more success than it has had with some previous efforts.
"Make no mistake, this is a very challenging population to reach," he said. "But that's why we're starting so early and using the simplest means testing application ever."
The additional help is for those whose incomes are at 150 percent of the poverty level and below -- about $1,200 a month for an individual or $1,600 a month for a couple.
Officials estimate that about 15 million people are eligible for the subsidy, and about half will be automatically enrolled because of their participation in other government programs. But that leaves about 7 million to 7.5 million people who will have to apply for the benefit.
Many of them also were eligible for a $600 credit that Congress approved as part of the Medicare Modernization Act of 2003. The credit could be used to defray the cost of prescription drugs. Yet, of the 7.5 million people eligible for the credit, federal officials say only about 1.8 million enrolled.
McClellan said the government has worked with grass roots organizations and pharmacists, who also will be receiving copies of the applications.
The Social Security Administration did a test run in March to gauge response to the applications. Findings from that test run won't be made public until later this week.
Patricia Nemore, a lawyer with the Center for Medicare Advocacy Inc., a nonprofit organization based in New York, said she was concerned that senior citizens would be put off by some of the 16 questions posed by the government. Those questions ask recipients to calculate the face value of insurance policies, and to calculate how much help they get from friends and relatives to pay for food, utilities and other bills.
"I think the whole process is so dastardly complex, it's bound to confuse," she said. "Those two questions in particular just go into areas that people don't have much experience in. ... And the language about going to prison for false and misleading statements is certainly likely to be offputting."
McClellan said the Social Security Administration used focus groups and outside sources to help them streamline the application as much as possible -- and still let the government obtain the information needed to determine if applicants met the eligibility requirements set by Congress. He said that while the application has 16 questions, many people will only have to answer 12.
"Line this application up against any other means-tested benefit," he said. "This one is the simplest by far. It's four pages, large type, fifth-grade level and no attachments. That's one thing about the process that's very different this time around."
In addition to the four pages of questions, the application includes a page of instructions and a page for the beneficiary's signature.
James Firman, the organization's chairman, said the current effort should do better than the one enrolling people for this year's $600 credit.
"There should be no doubt this is a good benefit," he said. "There was a lot of confusion about the drug cards, but there should be no doubt about this benefit. When in doubt, fill it out, is our belief about this thing."