Hundreds of thousands of older Americans who travel for extended periods face an added requirement in the complicated selection of Medicare drug coverage: choosing a plan that goes with them.
As they try to select approved coverage plans by a May 15 federal deadline, government officials and advocates hope "snowbirds" and "sunbirds" — retirees who live large parts of the year in different states — are reminded to pick national plans and not the dozens of regional ones that won't cover them or would cost extra at their temporary homes.
States that take in temporary summer residents don't have contingency plans if seniors discover their Medicare choice won't work elsewhere. State and federal officials and advocates say those in that situation would have to wait to change plans until an open-enrollment period in the fall.
Merle Kearns, head of the Ohio Department of Aging, said there's a concentration of snowbirds and sunbirds who split time between Florida's west coast and Ohio each year, but they usually spend more time in their temporary homes than the 90-day maximum pill supply covered by most prescriptions.
Kearns and some other government officials use advertising, media attention and counselors at senior centers or telephone hot lines to avoid such problems.
"My hope is people were proactive and mentioned they spent time out of area, because they can buy plans that are good everywhere in the country," said Ernie Boyd, director of the Ohio Pharmacists Association.
Sandy and Fred Gibson leave Fort Myers Beach, Fla., in May to spend five months at their Lake Erie beachfront home in Port Clinton, Ohio. They haven't thought about a portable Medicare coverage plan because they can't figure out if that would be cheaper than the $100 monthly premium and $348 out-of-pocket they pay now for 90-day supplies of eight medications.
"Now, at least we know we're covered," said Sandy Gibson, 66. "We order our medication over the phone, our insurance plan has a pharmacy in Ohio, and if we see our doctor in Florida, we can buy medicine down here."
The Gibsons are among the 43 million Americans eligible for Medicare's new prescription drug benefit. The 2003 legislation was intended to help seniors keep up with the rising cost of medicine, but critics say its complexity is discouraging people from signing up.
"This is a new program and people are trying to learn about it, and concerns about travel are questions people need to ask," said Scott Parkin of the National Centers on Aging. "It could be a problem, but we probably won't see this until more people start heading north."
Most retirees who spend more than a month at a time in different states spend part of that time in Florida. There were at least 818,000 snowbirds age 55 and older in 2005 who went to Florida temporarily in the winter, and 340,000 sunbirds who left the Sunshine State for more temperate summers, University of Florida demographer Stan Smith said.
A 1998 study also found that some 85,000 Arizonans left that state for at least a month at a time, with the number growing each year.
The government's Medicare information Web site, http://www.Medicare.gov, shows 43 stand-alone plans in Ohio and Florida, most of which offer national access to drugs and mail-order services.
Jackie Garner, the Centers for Medicare and Medicaid Services' Midwest regional administrator, said plan counselors and pharmacists should help seniors avoid any problems.
The Florida Department of Elder Affairs recognized that many seniors would want to choose a plan offered through a local pharmacy, so its counselors have made a point to direct snowbirds and sunbirds to national plans, said spokeswoman Erin Geraghty.
Rep. Sherrod Brown (news, bio, voting record), D-Ohio, who represents part of the Lake Erie shoreline and has advocated scrapping the new Medicare coverage during his run for the Senate, worries that some older people's traveling needs will be lost in the shuffle and they will end up locked into a plan that doesn't fit their needs.
"This is one more confusing aspect of a law that's perplexed seniors and confused the children of seniors who are left trying to help them out," Brown said.
Republicans and advocacy groups who backed the new Medicare coverage say that despite early confusion, the program has been a success for those who have signed up, saving the average beneficiary $1,100.
AARP's guide to the Medicare Part D notes that regional plans can work, as long as they offer mail-order services that allow drugs to be sent to a temporary address.