To the Editor:

Re ''Misgivings About Nudging the Elderly Into Managed Care'' (Seniority, March 9), which described the Bush administration's plans to use prescription drug benefits as a way to push older Americans into health maintenance organizations: As an elder care specialist, I counsel older adults, the consumers of the limited and confusing choices now available. Their frustration and anger when informed of the ramifications of these tough decisions usually lead to disillusionment.

Attempts to force older adults into Medicare managed care programs have failed in the past. Luring vulnerable older adults into a plan because of the promise of a medication benefit offers false security. Managed care plans can change their benefits, discontinue coverage in their geographic area and limit needed medical services simply by providing notice.

One program that does assist the middle-class elderly with their drug coverage is offered by New York State. Called the Elderly Pharmaceutical Insurance Coverage program, or EPIC, it helps people with their prescription drug costs without making them leave their current doctors and join H.M.O.'s.


Manhattan, March 9, 2003