Gov. Mark Sanford's administration is considering a plan to join more than half the country in paying for emergency medicines for seniors who are having trouble with Medicare's new prescription drug benefit.

Officials said Monday they were weighing whether the problems are still widespread enough to warrant paying for one or two months' supply of seniors' drugs. Doing so would add another layer to the already complex drug benefit.

"We're still trying to figure out the parameters," said Jeff Stensland, a spokesman for the state Department of Health and Human Services, which oversees the state's Medicaid program. "If we jump in, logistically it's going to be difficult."

Half of all states plus the District of Columbia have established emergency plans to help the poorest Medicare recipients get their medications in the wake of early problems with the new benefit.

One question is who will reimburse the state. "The federal government has been sending mixed messages on how that would work," Stensland said.

Last week, Medicare officials told the state that the insurers that provide drug plans should reimburse the state. Under that approach South Carolina would have to file claims with the 19 insurers that provide drug plans here.

The biggest question is the severity of the problem. The state was talking with pharmacists and industry officials Monday. Many advised the state against jumping into the fray, saying that the problems appear to be working themselves out.

Some 24 million Medicare beneficiaries nationwide have signed up for a prescription drug plan, including 3.6 million who've signed up voluntarily since November.

Most of the reported problems have to do with so-called dual-eligibles, the more than 6 million Medicare recipients, including 118,000 in South Carolina, who also get Medicaid, the state-federal health program for the poor.

Medicaid previously handled those seniors' drug costs, but after Jan. 1 Medicare took over. Medicare auto-enrolled those seniors into a plan.

Some recipients who switched plans weren't listed on a computer database with their new plan. Or the plan they were enrolled in didn't cover the specific medications they needed. Others were charged higher-than-expected co-payments.

Much of the blame is being aimed at the law that created the benefit, which required switching millions of seniors into new plans literally overnight. That task proved daunting.

"The first two weeks were crazy," said Tracy Russell, executive director of the South Carolina Pharmacy Network. "Any time you change insurance plans, there are going to be problems, and you have all these people changing insurance plans on the same day."

The problems with the drug plan aren't expected to end soon. Open enrollment continues until May 15. "We're expecting to continue to have these issues," said Terry Peace, vice president for group and individual operations for BlueCross BlueShield of South Carolina, which has 14,000 seniors in its drug plans. "But we don't know that they'll be to this magnitude."

Peace said BlueCross has been paying for medications for people who've applied, even if their applications haven't been processed by the federal government.

Russell said the problems appear to be subsiding since those difficult first few weeks. She said many pharmacies are paying for drugs themselves, especially for longer-term patients, and are awaiting payment from insurers.

"I'd be surprised if you found any more than isolated cases of a patient going without medicine," she said.

24 million

Seniors now getting prescription drug coverage through Medicare

6.2 million

Seniors on Medicare and Medicaid who were auto-enrolled in a prescription plan

3.6 million

Number of seniors who have voluntarily signed up for a Medicare drug plan since Nov. 15

600,000

Number of Medicare recipients in South Carolina

45

Number of standalone Medicare drug plans in South Carolina

Reach Jonathan Maze at 937-5719 or jmaze@postandcourier.com.