Medicare Part D - the D is for Disaster
The Mental Health Association of Southeastern Pennsylvania's consumer advocate, Fran Hazam, writes about her experience trying to help people in PA with Medicare Part D:
"It took me from Thursday until Tuesday to get one person straightened out. The pharmacists do not have the input information in a lot of cases. They don’t know how to enter the codes. They don’t know where to find the codes. They don’t know which codes to use.
We have a lot of people who had only Medicare Part A; that’s causing problems because caseworkers told them to opt out. They opted out of the auto enrollment and the new enrollment didn’t go through. Either they didn’t enroll in anything or, when they did enroll, it’s not showing up in the system.
One of our volunteers had a card from his new Part D plan and needed a refill. When he went to Rite-Aid, they could not refill his prescription. I called Rite-Aid corporate Friday and got a call back at 9 pm Friday night from somebody in the PR Department who said, 'We’ve trained everyone; they all know how to do it.'
On Saturday he went back to that Rite Aid and a different pharmacist told him he could only fill a new script; no refills written under his old plan. He then gave him 20 syringes he needed for insulin injections. Per the Health Law Project, the syringes are covered by Part D Medicare but the lancets and strips he also needs are covered by Part B Medicare.
Not one consumer I’ve talked to when things didn’t go through the computer was offered to be enrolled in Wellpoint/Anthem. The problem is that if pharmacists don’t enroll them in Wellpoint and they can’t get them to bill their new plan, consumers are getting enrolled in plans that don’t start until February 1 and pharmacists tell them they have to pay full costs until February 1.
Consumers, pharmacists and caseworkers don’t know which medications are not covered by Access cards: Barbiturates class, Benzodiazapam class and Diabetic supplies. People are being denied them when they should have just been asked for their Access card and have it covered.
So there are miscommunications of all kinds, and if people are not showing up with the letter that they got for enrollment or a confirmation number -- if they don’t bring all their information, including their Access cards -- they’re being denied.
This is really difficult for people. We’re lucky the weather is good; if the weather were bad, just getting out to the store multiple times would be a real problem for folks. It is a problem for consumers who have a distance to go and no transportation. Also, many need to get new scripts from their doctors and this slows down the process, depending on how busy the offices are."
This—the plan our government told us would be a boon for the elderly. What crap."
Posted by Christine Simiriglia.
"It took me from Thursday until Tuesday to get one person straightened out. The pharmacists do not have the input information in a lot of cases. They don’t know how to enter the codes. They don’t know where to find the codes. They don’t know which codes to use.
We have a lot of people who had only Medicare Part A; that’s causing problems because caseworkers told them to opt out. They opted out of the auto enrollment and the new enrollment didn’t go through. Either they didn’t enroll in anything or, when they did enroll, it’s not showing up in the system.
One of our volunteers had a card from his new Part D plan and needed a refill. When he went to Rite-Aid, they could not refill his prescription. I called Rite-Aid corporate Friday and got a call back at 9 pm Friday night from somebody in the PR Department who said, 'We’ve trained everyone; they all know how to do it.'
On Saturday he went back to that Rite Aid and a different pharmacist told him he could only fill a new script; no refills written under his old plan. He then gave him 20 syringes he needed for insulin injections. Per the Health Law Project, the syringes are covered by Part D Medicare but the lancets and strips he also needs are covered by Part B Medicare.
Not one consumer I’ve talked to when things didn’t go through the computer was offered to be enrolled in Wellpoint/Anthem. The problem is that if pharmacists don’t enroll them in Wellpoint and they can’t get them to bill their new plan, consumers are getting enrolled in plans that don’t start until February 1 and pharmacists tell them they have to pay full costs until February 1.
Consumers, pharmacists and caseworkers don’t know which medications are not covered by Access cards: Barbiturates class, Benzodiazapam class and Diabetic supplies. People are being denied them when they should have just been asked for their Access card and have it covered.
So there are miscommunications of all kinds, and if people are not showing up with the letter that they got for enrollment or a confirmation number -- if they don’t bring all their information, including their Access cards -- they’re being denied.
This is really difficult for people. We’re lucky the weather is good; if the weather were bad, just getting out to the store multiple times would be a real problem for folks. It is a problem for consumers who have a distance to go and no transportation. Also, many need to get new scripts from their doctors and this slows down the process, depending on how busy the offices are."
This—the plan our government told us would be a boon for the elderly. What crap."
Posted by Christine Simiriglia.
1 Comments:
It's actually helpful to me to hear about individual mishaps and stories that are occurring as a result of Part D. Until I started to hear these types of stories the whole change just seemed bureaucratic. Now I have a better idea of where people are having the most trouble, and it seems to be right at the pharmacies. So what can we do to better inform pharmacists?
-- Jennifer Melinn
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