Susie Tiffany of Beverly Hills suffers from a rare blood disorder and needs monthly infusions of blood components, which her insurance company ultimately declined to cover. She hoped the government's new prescription drug benefit would help her out because, despite her ZIP code, she's a low-income senior.
But the possibilities, were baffling: an array of private insurance plans that covered different things, explanations on the Internet that included terms she never had to know before, additional complexities depending on a person's income and a confusing interplay of state and federal agencies.
However, Tiffany was able to find assistance in her case from Jewish Family Service. A social worker helped get Tiffany's treatment covered by new state funds intended to help seniors with the transition to the new federal system.
"It's a good thing that I had a good social worker," said Tiffany, 65, who lives in a Beverly Hills city subsidized apartment building for low-income seniors.
"There are quite a number of options, and it's overwhelming," said Susan Alexman, director of senior services at Jewish Family Service of Los Angeles.
In Los Angeles County, insurance companies have offered 47 different plans for seniors seeking to enroll in the new federally funded benefit. The plan's May 15 deadline means seniors must sign up without delay or face increased fees for late enrollment.
For some seniors, the financial stakes are high. But while interest is picking up, for most of the past year, social service groups have had few takers when they've tried to help.
"It's strange, but our office has not had any calls on that," said Deborah Baldwin, public benefits supervisor at Bet Tzedek Legal Services, when asked in March.
At the Fairfax District office of the National Council of Jewish Women, a Democratic congressman's field staffer set aside four hours over two days in late January to discuss the new Medicare Part D drug plan with seniors. Hardly anyone showed up.
"Just three," the staffer told The Jewish Journal. "People are putting it off."
Health care activists, community workers and groups, including Jewish Family Service, have been holding numerous Part D awareness meetings, especially this spring.
"This has been going on for a year and a half," said Anita Chun, community education coordinator at the Center for Healthcare Rights in Los Angeles. "Now people are paying attention."
A Part D meeting in March in West Hollywood, put on by Jewish Family Service, attracted about 120 seniors. Attendance also picked up for a March meeting at Temple Isaiah in Rancho Park -- after a sparsely attended February session with social workers and experts.
Some seniors said they expect to come out OK under the new system.
"The health program that I belong to enrolled everybody in it beforehand," said Encino retiree Janet Siskind. Her Blue Shield 65 Plus coverage gets her quarterly refills of the three to four pills she needs. Siskind's combined prescription fees will increase, but only by about $10 annually.
"I'm in good hands with this," she said. "It's something I can afford."
Siskind's San Fernando Valley chapter of the Na'amat women's group held a recent Part D meeting for 25 people.
"We figured, 'Well, it hasn't started yet, perhaps it'll get easier as time goes along,'" she said. "It hasn't really been explained too thoroughly."
With so much Part D information online, many seniors are at a disadvantage, because of their discomfort or unfamiliarity with the Internet.
California's Medi-Cal program, which had covered poor and low-income seniors' prescription costs, stopped providing service on Jan. 1, when Part D took over. Yet there were startup problems, which included state and federal computers being unable to interact. Many poor seniors were suddenly being asked to pay full price for medications. The reports of hardship prompted Gov. Arnold Schwarzenegger and the Legislature in mid-January to push through emergency prescription drug funding for low-income seniors until May 15.
"It makes the state the payer of last resort for the prescriptions that they need," said Schwarzenegger spokeswoman Julie Soderlund.
But only until May 15, which could force Tiffany, suffering from the blood disorder, to navigate the system again.
"Good old Part D, the insurance policy that was gonna change it all," she said. "It's gonna take some time for me to get happy about it."
David Merritt, project director at the Center for Health Transformation think tank in Washington, D.C., said that despite such glitches, Medicare Part D transition problems nationwide have been relatively low, with Americans not upset over Part D the way they are over high gas prices.
"Anytime you have a massive policy shift from one system to another system, you're going to run into problems," he told The Journal. "The vast majority [of seniors] had zero problems enrolling or getting medication."
But to Jews dependent on Medicare for affordable drugs, "it's unfair for seniors to be expected to maneuver through this incredibly messy web," said Rabbi Zoe Klein of Temple Isaiah. "Health trumps every other problem in your life."
"They're basically saying they're confused, and they want someone to walk them through it," Klein said.