The Medicare Maze: Why Consumers Don't Know Which Way to Turn | Consumer Health Information Corporation

The Medicare Maze:

Why Consumers Don't Know Which Way to Turn

Katherine Kim , PharmD Candidate 2006
University of Maryland School of Pharmacy
Prepared during Consumer Health Information Corporation Clerkship
McLean, VA

Context: Medicare Part D, ratified from the Medicare Modernization Act of 2003, will commence January 1, 2006. Though enacted to assist seniors, this Medicare Prescription Plan has left nothing but a maze of confusion, conceiving a perplexity not only for the direct consumer, but also for caregivers and health care professionals, much of which is the result of poor health literacy.

Objective: To assess the health literacy and consumer readability of the Medicare Part D Prescription Drug Plan resources.

Main Outcome Measures: The readability of the literature dispensed to consumers falls at an unacceptable literacy level of grades ten through twelve. Other end points limiting consumer understanding include inadequate computer access for the elderly and poor structure of the literature.

Results: The results proved the high readability levels of much of the Medicare Part D information distributed to patients. They also showed the difficulty of choosing a plan based on primarily one or two resources, since the majority failed to include specific plan information required to make this decision.

Conclusions: Methods must be set in place before the re-application process in 2007 to better guide seniors into choosing a plan. The available information should be restructured to a comprehensible level for the average senior, yielding improved readability levels and better flow of the material. Until that time comes, many will find themselves lost in the maze, either choosing the least beneficial plan or, even worse, simply giving up on Medicare Part D.

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The history of Medicare is a timeline of events beginning in 1937 when the Technical Committee on Medical Care was established under the interdepartmental Committee to Coordinate Health and Welfare Activities. It is an ongoing procession extending into today, in an era of “Medication Modernization” and drug coverage for elderly citizens.

Medicare, a program of national health insurance for persons who are over the age of sixty-five or seriously disabled, was signed into law on July 30, 1965 under the Social Security Amendments. In the early 1950s, Social Security officials recognized that older Americans were facing a health care crisis. The Social Security system, which was created as an economic safety net for older Americans, was failing to protect them against the greatest single cause of economic dependency in old age – the high cost of medical care.

On December 8, 2003 the Medicare Modernization Act (MMA) was enacted. This law brought about the most dramatic and innovative changes to the Medicare program since its inception in 1965. Medicare Part D, ratified from the MMA will commence January 1, 2006, and with it comes much confusion among the elderly, their caregivers, and healthcare professionals.

The new drug benefit is anticipated to cost the federal government $720 billion over the first ten years. The average senior is expected to pay an annual deductible of $250 and approximately $32 in monthly premiums. Medicare will undertake 75 percent of drug costs up to $2,250. The coverage is then discontinued until the recipient has spent an additional $2,850 out of pocket, after which Medicare will assume 95 percent of all additional drug costs.

The 43 million seniors eligible for Medicare Part D are faced with a minimum of forty plans to choose from on average, reflecting the competition that supposedly promotes reduced costs, but also yields more consumer frustration. Each insurance company encompasses a variety of plans, which cover different prescription drugs at various rates and monthly premiums. Plans also differ by state and pharmacy and sometimes, but not always, include mail-order drugs.

The process of choosing a plan sounds as confounding as it is. Thus, according to Medicare.gob, “because this new coverage is so important, the Centers for Medicare & Medicaid Services (CMS) wants to promote a national conversation to make sure that all people with Medicare, and those who care for them, understand this new coverage. This conversation will take place in many different places and in many different ways – it will occur across the kitchen table, in senior centers, at churches, between friends, neighbors, parents and their children, pharmacists and their customers.”

Yet the problem lies in the health literacy of the abundance of information allocated to the consumer. The Kaiser Family Foundation and the Harvard School of Public Health found that more than six in ten seniors understood the drug benefit “not too well” or “not well at all” although 74 percent received information regarding the new benefits. Nearly three-quarters of those surveyed said the large number of choices “makes it confusing and difficult to pick the best plan.” Thus, to ensure the success of this new drug plan, companies must make all pertinent information easily accessible, applicable and comprehensible to the average senior. This article will discuss the setbacks and obstacles many consumers have encountered while stumbling through the maze of choosing a Medicare prescription drug plan.

METHODS
Data Sources

A multitude of resources available to the consumer were examined for readability, ease of use, and structure along with patient understanding and interpretation. Despite the confusion and frustration brought on by Medicare Part D, there are a copious amount of resources available to seniors including, but not limited to, pamphlets, telephone sources, and online services.

Hard Copy Sources
Various pamphlets and packets, which are readily available to consumers, were read, analyzed and researched for readability levels (via Microsoft Word Perfect Version 12). Ease of use and the order of information presented were also examined based on the average senior’s level of understanding and interpretation.

These hard copy sources include the following:

Medicare & You, a booklet dispensed to all who are eligible to receive Medicare
Understanding the New Medicare Prescription Drug Plans by Prescription Pathway
Your Medicare 2006 Prescription Drug Plan Decision Guide by CVS/Pharmacy

Telephone Sources
Three random telephone resources available to consumers were phoned and examined based on length of call, ease of use and assistance. All were called during peak daytime hours and asked to allocate the same data - general information about drug plans so the patient could more effectively choose a plan. The child of a senior, helping their parent through Medicare Part D, placed the calls. 1-800-Medicare (1-800-633-4227), Humana (1-800-457-4708), and AARP (1-888-687-2277) were called.

According to the Kaiser Family Foundation, 69 percent of seniors have never utilized the Internet and thus do not have easy access to computer or online services. Consequently, these Medicare participants must employ either these hard copy or telephone resources to research Medicare Part D.

Online Sources
Some of the most utilized Internet resources were analyzed for readability (via Microsoft Word Perfect Version 12), structure, and comprehension. These sources include Medicare.gov, Medicarerxeducation.org, http://www.disabilitybenefits101.org/ca/special/partd/feature.php, http://www.egyptianaaa.org/MedicareDrugBill.php, http://www.aarp.org/bulletin/medicarerx/.

Medicare.gov
We navigated the site as a consumer to find the best plan given explicit criteria, including a list of medications, pharmacies and a specific region of the country. The medication list included Imdur 30mg ½ tablet daily, hydralazine 10mg every day, and furosemide 20mg 1 tablet alternating with 2 tablets every other day. Virginia (zip code 22102) was the defined area and all pharmacies within 4.75 miles were specified. Our method employed the following:

Begin at www.medicare.gov
For information regarding Medicare Part D, click on “Want to Learn More About the New Medicare Prescription Drug Coverage?”
To begin to search for a plan, click on “Landscape of Local Plans” from the Medicare.gov homepage.
Scroll down and click on the link beside a specific state. This will produce a chart of all existing plans for that state. Print this chart.
From the Medicare.gov homepage, select “Formulary Finder.”
Choose a specific state from the scroll bar. Enter in medications one at a time.
Choose the exact dosage by selecting “Choose drug dosage.”
Click “Continue with selected drugs” to view all plans that cover your specific medications.
Highlight those plans that cover all your medications on the printed chart (which shows plans available in your state – see #4).
From the Medicare.gov homepage, click on “Compare Medicare Prescription Drug Plans.”
Click on the orange arrow next to “Find a Medicare Prescription Drug Plan."
Choose “General Search."
Type in specific zip code, current prescription drug coverage, and whether or not you are eligible or qualify for additional help.
On the next page, select “Choose a Drug Plan Type.”
Select either “Search for Medicare Advantage Plans” or “Search for Medicare Prescription Drug Plans.”
Choose “Enter my medications."
Type in each drug name and if you wish to use “lower cost generic drugs when available.”
Select “Choose my dosage” and indicate your exact dosages.
Choose “Continue with selected drugs” when finished.
Click “Select My Preferred Pharmacy.”
Select “Continue to Pharmacy Selection.”
Choose pharmacies within 3 to 8.25 miles of your entered zip code.
Choose to “Continue with Selected Pharmacies” to view a list of plans recommended by Medicare.gov.
You can then click on the name of each plan to view specific information about that plan.
Compare these plans and the highlighted plans (see #9) to choose the one that best fits your needs.

Pharmacy Sources
Stores from four large pharmacy chains were interviewed regarding the number of consumer questions they receive about Medicare Part D and the content of their response. One of each store from the Giant, CVS, Rite Aid, and Walgreen’s corporations were questioned.

RESULTS
The results proved the poor literacy level and incomprehensibility of the resources. They also showed the difficulty of choosing a plan based on the following sources, most of which do not offer any specific information on the various plans and/or formularies.

Hard Copy Sources

Medicare & You

The 98-page booklet was released by The Centers for Medicare and Medicaid Services (CMS) to give seniors a comprehensive view of the entire Medicare program. However, this adds complexity for those who seek to research Medicare Part D exclusively. A discussion of the new drug program is begun on page 1, yet it is not until page 39 that the remainder of the information is given; the sections in between explain Medicare Parts A and B. The cover page of the booklet is also misleading. It states “turn to Section 1 to see what you need to do and to learn about your prescription drug and health plan options.” However, Section 1 is no more than four pages in length and fails to list the drug plan options (which are seen in Section 6 of the handbook).

While the font size is enlarged to aid those with poor eyesight, the color choices are not optimal for easy reading. The blue and black fonts on a blue background (found on many important notes throughout the booklet) prove to be more difficult on the eyes than black on white or vice versa.

The structure of the information may also be confusing for the average senior. Page 42 for example (see attached sheets) contains a chart with unclear conjunctions and arrows leading to nothing. The arrows on the sides of a page (for example page 47 – see attached sheet) are also perplexing. It is unclear as to if the arrow pertains to all of the bullet points beneath it, or rather to the single bullet to which it is pointing. In the same regard, the order of information is less than optimal. Many pertinent examples are moved near the end of the page instead of directly below the applicable topic (example page 48 – see attached sheets).

The literacy level is also beneath acceptability. The content should be based on a 6 to 8th grade reading level for the average consumer, yet the readability for the “Getting Started” section was found to be 10.11.

Although the above findings are unsatisfactory, the most frustrating aspect of Medicare & You is the fact that the consumer cannot choose a plan primarily from this booklet. The appendix at the end of the handbook lists in chart form the plans available in that state. However, this does not contain any detailed information about each plan, such as the specific co-pays and co-insurances, whether the plan has regional or national coverage, or the exact counties in which a specific plan is available (instead the service area is listed as “selected counties”). The numerous insurance companies offer a wide variety of plans, each containing different explicit options; thus, members cannot choose a plan based on this over-simplified information.

Understanding the New Medicare Prescription Drug Plans

This pamphlet is endorsed by Prescription Pathway, and so includes a chart regarding the four plans they offer and somewhat detailed information on each. The specific co-pays and co-insurances, deductibles, and premiums are defined in the chart, however the consumer must call Prescription Pathway to ensure the plan is available in their area.

The booklet does not give the consumer any insight into better understanding Medicare Part D; it merely lists some definitions, reminder dates, and common questions. The readability for this handout falls at a grade level of 11.0. Also, since Prescription Pathway arranged this pamphlet, it does not list any other drug plans; and thus the consumer cannot choose a plan based on this booklet.

Your Medicare 2006 Prescription Drug Plan Decision Guide

This pamphlet is made available by CVS/pharmacy and helps to guide the consumer into choosing the best plan. If offers limited information on Medicare Part D and provides a prescription drug coverage worksheet. This worksheet allows seniors to compare up to six different drug plans. However, this demands that the consumer have specific information about the different drug plans, and be informed enough to choose six plans to compare.

To obtain a list of drug plans per region, this pamphlet refers the consumer to the Medicare & You booklet, which offers no such information (it merely lists the state or “selected counties). Visiting Medicare.gov is also suggested, but not an option for those with no computer or Internet
access. Thus even with this guide it would be impossible for some to compare plans.

The worksheet also prompts the consumer to list their medications, a seemingly helpful tool when researching formularies. However knowing brand versus generic (information unknown to the average senior) is crucial when analyzing a formulary. In the end, this pamphlet brings us to the same place – confused and unable to choose a plan from the dispensed information.

Telephone Sources
Medicare
While this 800 number is the major telephone service available from CMS, it proved to be the least user-friendly. The prompts were voice activated only, a feature that may be difficult for elderly users with speech impairments. The automated menus were so lengthy that by the end the consumer may forget what it is they need to say. This service does provide information on Medicare Part D, however it is not presented at a 6-8th grade comprehension level.

This hotline is advertised for consumers to sign up for a plan upon calling, a task that is certainly not straightforward. Throughout the entire sequence of menu options, there was never a choice to sign up for a plan or speak to a representative. At the very beginning, the caller is told to voice “help” if he/she ever did not understand his options. However when this is done, the command is not understood and the caller is told to “please choose one of the previous options.” Eight minutes elapsed before two PharmD candidates stumbled upon the method needed to speak with a representative – simply pressing “0,” an option the automated system failed to mention. When finally speaking with a representative, we found that 1-800-Medicare could not offer any assistance without all of the patient’s personal information.

Humana
This telephone service is provided for consumers to gain more insight on the specifics of all Humana plans. Although we were quickly connected to a representative, only basic information about the plans, such as the annual out-of-pocket costs and premiums were obtained. This insurance company would give detailed information over the phone, however we were speaking with an unlicensed agent who was not knowledgeable on any specifics. We were told the licensed agent could disclose the details on co-pays and co-insurances, yet there was no licensed agent from our area in today and we should call back on Monday of the following week. In addition to this disservice and inconvenience, the representative was uneducated on medications (brand versus generic) and could not give concise explanations on “co-pay” versus “co-insurance.” The total call length was 11 minutes.

AARP
This telephone service had an option to “press or say” a selection, a feature that is more convenient for many seniors. Again we were quickly connected to a representative, although this company’s policy was not to disclose information to anyone except the direct consumer. This was done to reduce the amount of skewed information given to the consumer, a good intention but inconvenient aspect of the service. If an elderly patient had dementia or suffered a stroke and were physically and/or mentally incapable of speaking to a representative, and in addition have no access to a computer, they and their family have no way of obtaining specific plan information regarding the AARP drug plan.

Online Sources
In January 2005, the Kaiser Family Foundation found that less than 31% of senior citizens have ever gone online. In addition, seniors whose annual household income falls below $20,000 a year are 85% less likely to have used the Web, yet 64% of seniors on Medicare fall into that lowest income category. Many seniors also suffer from visual impairment, arthritis, and other such diseases making it very difficult to navigate Medicare part D online. Despite all of this, the most convenient and timesaving method to research the new drug plan is via the Internet.

Medicare.gov
Aside from it being inaccessible for days at a time, its system is difficult to follow. The web site is the only place that allows the consumer to observe which plans would best fit their needs (by entering in his/her state, medications, and preferred pharmacies). It also allows consumers to view specific information on each plan, including the exact co-pays and co-insurances, deductibles, premiums, and whether the plan offers regional or national coverage.

It was very difficult to navigate the web site to locate pertinent information. It was only after clicking on various links multiple times and cumulating unwanted information that navigating the site became a little less tedious. It was difficult to access the information available due to repetitive links and confusing lingo.

The readability of the website was not fit for proper consumer understanding. The content should be based on a 6 to 8th grade reading level for the average consumer, yet for the link “Basic Information on Medicare Part D,” the grade level readability was 11.85 with a 66% vocabulary complexity (not a far cry from the 10.11 readability of the “Getting Started” section of Medicare & You). “Things to Consider,” the document to better help seniors understand the Medicare lingo, has a grade level readability of 9.27; while this is an improvement from “Basic Information,” it is still not at an acceptable level to ensure consumer understanding.

To find the best plan, one must first go to “Landscape of Local Plans; State-By-State Breakdown” from the home page of the website. They then scroll down to the state in which they reside and click on the link to view the specific plans available in their state. The file that pops up is in PDF format (something the elderly may be unfamiliar with). The chart’s font size is very small and virtually incomprehensible. This chart can be enlarged via the zoom button. Nevertheless, most elderly patients do not know that the zoom button exists, let alone where to locate it on the screen. But, if the consumer was to zoom in until the document is enlarged to a readable font, the chart is three times the size of the screen and is extremely difficult to view properly. If the patient chooses to print the chart, the font size will be minutely larger, but still not at a level that most seniors could easily view.

Once the patient has analyzed the chart, they can then proceed to “Compare Medication Prescription Drug Plans.” There they can choose to do either a personalized or general plan search. The screens that follow are messy and difficult to understand. The information is presented in a confusing manner and the text displayed in a small font. It is hard to differentiate what button to click on and when it should be clicked.

On Step 4 the patient can enter in their medications, one at a time. This may also be confusing.
For example, if “hydralazine” is entered, the patient must choose from the following: “Hydralazine HCl”, “Hydralazine/Hydrochlorothiazide”, or “Hydralazine/Reserpine/HCTZ.” This may appear to be a simple choice. The consumer should be able to eliminate the last two options and choose “Hydralazine HCl.” However, if the patient’s bottle only says “Hydralazine,” it is very possible that they could mistake “Hydralazine HCl” for being a completely different drug.

The program also demands the patient to know brand versus generic medications. When typing in their drugs, they may choose to “use lower cost generic drugs when available.” This is a very crucial choice when researching which formularies cover which drugs, yet this option is in very small font and could easily be missed.

If the consumer makes it to Step 5, they will have in front of them the list of plans that cover their specific medications in order of best to worst (the most savings per year to the least), derived from their specific criteria. However, in order to make an intelligent decision, they should compare all of the possible plans. The web site only allows the comparison of 3 plans at a time; thus if they went this route, they would be comparing all day. But there is another possibility – printing out the small barely-readable chart containing the plans for their state and what each has to offer. The patient can then compare the plans in front of them more easily – providing their vision is good enough to see the chart.

There was one last obstacle to hurdle while comparing the plans. In the list of the “best plans for me” (Step 5 on Medicare.gov), they listed “Secure Plus 15.” However, there are 2 existing Secure Plus 15 plans. It was difficult to decipher which plan pertained to my list.

Although this web site can prove to be very confusing to many seniors, the “FAQ” or “HELP” link is not easy to find. It is hidden at the top in the Blue banner in small white letters. When the consumer clicks on the “FAQ” link, it produces a long list of questions that must be scrutinized to find the answers to any questions they may have. The questions and answers may be easier to access if they were categorized under titles such as “important dates”, “choosing a plan”, “Glossary”, etc.

The most significant factor of this website remains that it is the only resource that allows the consumer to observe which plan best fits their needs by producing for them a list of plans that matches specific criteria. However the interactivity of the databases is cumbersome and difficult to work with, making it impossible for some to reach the end of the maze.

MedicareRxEducation.org
This web site was also designed as a resource for Medicare drug coverage information. It is much easier to navigate versus Medicare.gov. The choices and links are clear and the pages are a lot less cluttered. Another advantage of this site is the option of increasing the font size of the entire page. This will be very helpful to many seniors suffering form visual impairment. Also, none of the data requires PDF capabilities, thus reducing some unnecessary confusion. Although it is not as tedious and cumbersome as Medicare.gov, its level of patient comprehension is much worse. The grade level readability for the site was 12.9, not coming close to the desired 6-8th grade level. Also, while this site offers a worksheet to compare plans, there is no specific plan information accessible via this resource, making it impossible for seniors to choose a plan from this site only.

www.disabilitybenefits101.org
This source presents Medicare Part D information in an easy to navigate format with no PDF files. However, the font size is rather small, with no option of enlarging it. This site offers no capabilities for the consumer to compare plans, or any specific information regarding the various plans, including information on formularies. Thus, the consumer cannot choose a plan based solely on this resource. Additionally, the grade level readability of the document was an unacceptable 10.10.

www.egyptianaaa.org
This web site is not optimal for proper patient comprehension. Although the consumer is not required to possess PDF capabilities, the font is small and there are too many words crowding the page, making it difficult to read. Again, this site offers no capability to choose a plan directly, referring patients to Medicare.gov for this access. Also, the grade level readability proved to be the worst at a 14.16 grade level.

www.aarp.org
Access to the Medicare Bulletin does require the user to have PDF capabilities. Another disadvantage is that the font size is small and the pages are very cluttered. However, the information is rather complete, answering most of the questions posed by seniors. Also, this web site had the best readability of a 9.36 grade level, marking it as the resource that came closest to our goal of 6-8th grade. While the site does offer suggestions on choosing a plan and a worksheet to aid this process, it does not provide any specific information on the various plans, leading us down the familiar road of not being able to choose a plan based on this one resource.

Sankyo
Various drug companies such as Sankyo are trying to shed some light on this issue by developing consumer presentations, while actually these readability levels are even gloomier. The grade level readability for Sankyo’s slide show was 10.46. However, the most crucial element of the presentation, the introductory slide, had an atrocious readability of 13.66. And if the consumer is not able to comprehend the information from the very beginning, the rest will be just a downhill slope.

Pharmacy Sources
Phone calls were placed to four large chain pharmacies to evaluate how they were assisting seniors through this confusing process. The involvement level was greatly varied between the chains, naming CVS/pharmacy as the most prepared and thorough, with the remainder falling below an acceptable level of patient assistance.

Walgreen’s
Although the store is relatively new with a limited number of customers, they admitted that a significant percentage of questions asked were regarding Medicare Part D. The pharmacists dispensed brochures outlining three local plans along with a booklet about the basics of the new drug program. The patients were told to compile a list of their medications and to contact specific insurance companies to verify that their drugs are covered on each formulary. Consumers were also referred to both Internet and telephone resources.

While the above efforts may prove helpful to some, they will be of little or no assistance to most. The pharmacists dispense three different plan brochures, but what if none of these is the best plan for the patient? Also, patients are sent on their way to research the Internet and telephone services alone, both of which have been proven to be inadequate for many seniors.

Rite Aid
This store also experienced numerous patient questions about Medicare Part D. However, they were cited to be even less helpful than Walgreen’s. The pharmacists agreed that the pamphlets and booklets dispensed to consumers were confusing. Rite Aid does offer a Medicare training program for both pharmacists and technicians, yet they still cannot get a grasp on the material. They claimed to “do their best” to answer customer questions, a not-too-hopeful response for many confused seniors.

Additionally, to relieve some of the burden put on pharmacists in the recent months following the initiation of Medicare enrollment, a representative from Medicare was scheduled to perform weekly patient sessions at the store. However, he canceled so frequently that this particular Rite Aid dropped the program altogether.

Giant
This store proved to be the least prepared of the four. The pharmacists admitted that they only Medicare Part D training they received was a mandatory online program composed of four modules. Upon completion, each pharmacist received two Continuing Education credits. This is hardly sufficient training to prepare pharmacists for the abundance of challenging Medicare questions.

When asked about the new drug plan, pharmacists dispense a few pamphlets to the senior and tell them to call the individual insurance companies to “see which one is best.” The pharmacist also disclosed that they had a handout containing general information on Medicare Part D, however he “didn’t think it was helpful at all.”

CVS/pharmacy
This chain demonstrated proactive patient counseling and provided seniors with a multitude of helpful information on Medicare Part D. Both the technicians and pharmacists were well trained on the subject. One technician was also designated as a “Medicare Specialist” to offer extra counseling to confused patients. A “Medicare Question Day” was set in place for seniors to come and ask any questions regarding the new drug plan. The store also offered a kiosk filled with brochures explaining information from “the basics” to describing in detail the different plans.

In addition, CVS offers an interactive Medicare guide on their website. The CVS.com Prescription Drug Plan Information Center details the Medicare Prescription Drug Plan using imagery, text and audio. The online information center features closed captioning and video to allow equal access for people living with cognitive, visual, audio or motor limitations. It also allows the viewer to increase the font size if needed. This site can be accessed via http://www.cvs.com/medicare.

CONCLUSION
The Centers for Medicare and Medicaid Services recognizes the problems seniors are encountering and is making an effort to ease the transition.

Key Partnerships
The Center for Beneficiary Choice has expanded its partnerships with other federal government agencies, such as the U.S. Department of Housing and Urban Development and the U.S. Department of Agriculture, to reach Medicare beneficiaries with basic information about the new benefit. They are also working with community health centers and disproportionate share hospitals to reach out to the low income population, and will continue their relationship with the state health insurance assistance programs (SHIPs) and area agencies on aging (AAAs). Medicare has an Outreach Toolkit is designed to equip community-level organizations with the materials needed to provide clear, accurate information and assistance to their clients on the Medicare prescription drug coverage. The toolkit is developed with basic, straightforward information that can be easily conveyed to beneficiaries and it can be ordered on the Medicare website.

In addition, there are students from health care related schools that are also offering a hand. University of Maryland School of Pharmacy in conjunction with the Division of Medicare operations from CMS is also trying to contribute to the enrollment of beneficiaries. They asked their students to volunteer for an enrollment event that is to be held at one of the senior centers in Baltimore and to bring their laptop to help out with the enrollment process. The students had to go through a training process to be able to help enroll the beneficiaries.

The Road Ahead
Various methods must be set in place before the re-application process in 2007 to better guide seniors into choosing a plan. The available information should be restructured to a comprehensible level for the average senior, yielding improved readability levels and better flow of the material. Until that time comes, many will find themselves lost in the maze, either choosing the least beneficial plan or, even worse, simply giving up on Medicare Part D.



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