Not all of the local pharmacies contract with all of the 20 companies offering Medicare Part D for prescription coverage. Not all of the local pharmacies are offering personal assistance. Phone calls to all of them revealed new depths of this iceberg of Medicare Part D.

Teresa Matthias, office manager of Cloney's two Eureka locations, said that their staff is helping current customers and others as fast as they can.

Since the pharmacy has the customers' lists of meds on file, they only need to call with their Medicare effective date to begin the process. Staff will pull up a list of plans that fit the customer's needs. They can help customers to compare options but can't recommend a specific plan.

Cloney's also handles the prescriptions for county mental health, public assistance and several of the local skilled nursing facilities. Many of those people are "dual enrollees," that is, enrolled in both Medicare and Medi-Cal.

Dual enrollees have a different task than the rest of Medicare members. Dual enrollees are automatically put into a new Part D prescription plan, and they can change their plans more frequently than regular Medicare recipients. Although they are automatically enrolled in a plan, it may not be the best plan for them, and so they too should follow up to make sure they've made the best choice.

Shannon Bailey, pharmacy technician at Lima's Eureka, said that customers can bring their plan info to Lima's and staff will get on Internet to check and see if their meds are covered. They are receiving at least two requests per hour for this service. Lima's is not contracted with two of the plans.

Erin King-Michael, general manager of Redwood Pharmacies, said that staff members of both Henderson Center and Myrtletown sites are not sitting down with individual customers to help them explore plans on the Internet.

She added that she has an insurance agent ready to come for a workshop about Community Care Rx, one of the 20 companies on the list, and is the one her independent pharmacy is supporting. "They cover 80 percent of the 200 drugs on the list, allow patients to keep their prescriptions at local pharmacies, and there's no mail-order requirement.

"It's not clear in these plans at first, but a lot of them will require customers to go to the large chains or have their prescriptions filled through mail order," she added. "So this plan doesn't require that, which is good because our Henderson Center customers like to come in and get their prescriptions filled."

Kim Kelley, clerk at Barnes, said that their staff can give customers a list of the plans they're contracted with, and that people need to call the plan itself to find out if their list of meds are covered.

Daniel Bywater, pharmacy manager, said that they are trying to answer any questions their customers ask and will sit down with customers to explore how the different plans could serve them.

"The biggest challenge is to get people to understand what is changing," Bywater said. "They are happy with the coverage they have now and they don't want to change." He said that his customers are a mix of Palco employees and retirees and others, but the Palco dropped its retiree pharmacy policy to go into Part D. "I'm sure we'll see a lot of employers doing that," he added.

Lee Miller, pharmacy manager at Longs, Harris Street, said that his staff gives out a card with the Longs Medicare Benefits Hotline phone number, 800-568-2155, and their web site, www.longs.com, where customers can check the 48 plans to see if their own meds are covered. Longs staff can't recommend any specific plan because the company is financially involved in some of the plans.

Miller also described the reality of the pharmaceutical business, "Every January we deal with [an awkward time] because every year the insurance companies change the rules. Now we're dealing with 48 new sets of rules."

He said that half of the questions he has asked the different insurance companies in the new Medicare Part D plans have come back with an unsettling answer: "I don't know, we're still working on that."

"But we'll handle it," he added. "It will all shake down in a few months." Miller added that a lot rests with the physicians who prescribe something that their patient isn't insured for. That discovery will be made at the pharmacy computer when it comes up not covered by the patient's plan. Then the physician will have to contact the insurance company to get an exception, or change the med.

Michael Cent, pharmacy manager, said that their staff is getting prepared by viewing a Costco training DVD. They are not allowed to make any recommendations about specific plans and are referring customers to the Senior Resource Center for individual help in making their selection.

"It may seem confusing to people now," Cent added, "but it's not to us. The underlying platform of these new plans is exactly like the insurance cards we take every day. Once people get over the initial hump of making their selection, it won't be confusing for them."

Yumon Kwock, Rite Aid pharmacy manager in Eureka, offers pamphlets to people but no individual assistance, except to customers who come in with caregivers. They can't make recommendations but will carry almost all the plans. "They're still working on the formulary," he said. "It's still changing, so we can only say that the majority of drugs will be covered. There will always be a few that aren't."

The Health Insurance Counseling and Advocacy Program (HICAP) has scheduled a number of informational sessions.

• Monday Jan. 9, 3 p.m. St. Joseph's Hospital, Eureka
• Thursday, Jan. 12, 1:30 p.m. Humboldt Senior Resource Center Dining Room, Eureka
• Tuesday, Jan. 17, 2 p.m. Ferndale Town Hall, Ferndale
• Tuesday Jan. 24, 1:30 p.m. Sapphire Palace, Blue Lake Casino
• Tuesday, Jan. 31, 1 p.m. Table Bluff Reservation, Loleta

HICAP staff will also be available again at the Humboldt Senior Resource Center to offer assistance with choosing Medicare providers Monday, Jan. 9, and Wednesday, Jan. 11, in the Computer Lab. This is one-on-one help with decisions and deadlines. Call HICAP, 443-9747, for an appointment.