Promoted from the diaries by Steven D with some minor edits.
According to an article in Forbes the problems w/Medicare D are now being shifted away from the “insurers” and is being placed on those who followed the advice that was given to them re: choosing a plan that would pay for all of their prescriptions!
Medicaid recipients….were auto-enrolled by the agency into a private Part D plan. But some also went ahead and chose another plan in the run-up to the Jan. 1 deadline. The result? Data regarding their choice of a private plan made it into the system, but information as to their ongoing status as an eligible Medicaid/Medicare recipient did not.
And, some switched to a different plan, trusting information given to them that the plan a person switched to would cover all of their prescriptions. However, this didn’t always happen, despite the fact that,
under Part D rules, the new plan was required to cover the drug for a 30-day period.
Bill Vaughn, a health lobbyist and senior policy analyst at Washington, D.C.-based Consumers Union (which publishes Consumer Reports) described the federal government’s rush to implement Medicare D as:
“breathtaking arrogance.”
Vaughn further used a 2004 government study from the Medicare Payment Advisory Commission to illustrate his point. The study found that transferring an enormous number of files from one insurance carrier to another averages approximately SIX MONTHS
He then added:
“But here you have people in Part D signing up beginning on Nov. 15th for a program that starts Jan. 1 — with some people even signing up Dec. 31st. And you expect them to get a prescription by January 2nd? It just won’t work.”
Now from Medicare spokesman Peter Ashkenaz:
” Congress created the Part D program to begin January 1, 2006.”
And, according to the Final Vote Results For Roll Call 669, the Medicare Prescription Drug, Improvement, and Modernization Act, was enacted on November, 22, 2003!!
Ashkenas also claims that the new system has a built-in:
“safety net…if a beneficiary is found not to be in a plan, the pharmacist has the ability to sign that ‘dual-eligible’ up to a plan right there at the counter …”
Robert Hayes, president of the Medicare Rights Center, states that he had a discussion with Mark McClellan, (Administrator of the federal Centers for Medicare and Medicaid Services) EARLY LAST YEAR:
“I was sitting in McClellan’s office and I said, ‘Look, even if you get this transition 99 percent right for the people losing Medicaid coverage, you’re still going to have 64,000 people without drug coverage come Jan. 1.’ And [McClellan] said ‘No, we have everything under control.’ “
However, according to New York City-based “information designer” Leslie Smolan, patient information remains split among the agency, doctors, pharmacies and insurance plans — each with its own computer system and “language,” as opposed to a centralized computer network/system that would allow all to share the same information/codes. Smolan also added that Medicare D should have had some:
“[B]eta testing…what any business creating any kind of product would do — make sure it works, then roll it out…Now, it’s just damage control.”
x-posted at dkos and mlw
BTW, anyone catch the irony of the date of the roll call? 40 years after JFK’s assassination!!!
Just like in New Orleans. And people are drowning again.
LTE time!
Not me. I’m blacked out until Feb. 12. 🙁
Damn 30-day limit. Blew my monthly LTE on the Abramoff scandal.
Till 2/12, you can sure find a hell of a lot of info. Or write one and have a friend submit it!
live in cities distant from you, be aware that they are likely to tell you that they have obtained their medication even if they have not.
This is because if they are not on “the list” or their medication is not, it is likely that the pharmacist will be askig them to hand over as much as a couple of thousand dollars for a month’s worth of pills, depending on how many medications they are taking, what they are, etc.
Do not count on them to ask you for this money, even though you have assured them that they can, told them they damn well better, etc.
Do what you can to assure that they do have it. If at all possible, take a day or two off from work and go visit them, or have a relative who lives nearer do it.
See for yourself, or have the relative see, that they have ALL of their medication, and money for next month’s. If they will not take money, go to the drugstore and buy it and put it in the medicine cabinet. Do whatever is necessary to see that they have it.
Can always count on you to give the best advice–love you for it!!
Single-payer.
CNN Headlines:
Easy sailing expectedfor Alito
Canadians choose a conservative
Bush: NSA wiretaps targeted and legal
Report: Evidence indicates U.S. was “outsourcing” torture
Just another morning in Bush’s America.
Thanks! Am so engrossed in Medicare D, I can’t keep up w/much else!
Add into the chaos that prescription prices spiked in November & December and that doctors are not getting the samples they were before this fiasco went into effect. My mother’s doctor usually provides her with samples but on our visit the first of this month, he didn’t have samples of two of her meds, only one week of another. The one that he was able to give her will save her about $150 but otherwise her prescriptions run now about $500 a month. We’ll hopefully get her into one of the plans soon, but there’s something inherently wrong with insurance that you’re stuck with for a year that can change their formulary on a monthly or weekly basis. In my dictionary, that’s called bait & switch.
My Mom retired from state work and has blue cross. Medicare has paid nothing on her medicines. Blue Cross sent her a letter saying if she picked a Medicare plan she would be dropped from Blue Cross. She wants to stay with Blue Cross, but if she doesn’t pick a Medicare plan and is put on one she’s left out in the cold. I wish they could use the old drug abuse saying “Just Say No” for this Medicare farce.
You have to wonder if this isn’t a neo-con plan to “save” Social Security – kill off the elderly by messing up their insurance and their prescription coverage so there are fewer of them collecting.
Mom has a Medi-gap policy from Blue Cross, but when I called them they said that her prescription plan was just a discount and not coverage so that plan does not have to change if she gets Plan D coverage, she just wouldn’t get the discount anymore.
I’m really at a loss to figure out what to do. My mom doesn’t understand any of it and everyplace I’ve gone to I can’t get a straight answer. That is when I can get someone to talk to me. I just wish these congressmen/congresswomen would have to live on a fixed income without their hefty retirements and see how it is when medicine to keep you alive takes a major part of your income.
I just wish these congressmen/congresswomen would have to live on a fixed income without their hefty retirements and see how it is when medicine to keep you alive takes a major part of your income.
Think that you have figured out a partial solution to the budget problem!!! Hell, I wish they had to live on a fixed income when they were in office!!!
(I am also on a fixed income (SSD/I).)
if she doesn’t pick a Medicare plan and is put on one she’s left out in the cold.
That doesn’t sound right to me, but no one really knows wtf is going on w/this…beneficiaries, case managers, doctors, pharmacies….
From some of the info that I have read, this is probably news to many pharmacists, not that they don’t have enough to do already:
Thanks for the reply Street kid. I don’t know if it’s right or not. I thought I remember hearing if you hadn’t picked one you would be put on one after a time. I’ve been trying to find out if that is true or not. I just want to make sure she is not inadvertently put on Medicare D.
I thought I remember hearing if you hadn’t picked one you would be put on one after a time.
Believe that you are correct…am doing so much, my head is spinning…
And how about this?
compared to this?
Follow the link–it gives a running total of the cost of the invasion of Iraq (currently 236 BILLION +).
Prioriries? (rhetorical ?)
Thanks for the links. It’s infuriating to know all that money could be used to help the poor in this country. The only priorities they have are to take the country for all the money they can get.
As you said this is all very confusing. My understanding so far is the only people that will be automatically enrolled into a plan are the people who are very poor-called ‘dualies’ who are on Medicare and Medicaid in their state. (which is what happened to me)
So far I think if someone on Medicare has another insurance plan such as your Mom she can keep this plan if it suits her. However if something happens with her Blue Cross plan and she does decided to sign up for a D plan she will be penalized at 1% for every month she had not signed up …if she didn’t sign up for say two years then her premium would be 24% higher than normal price that plan charged.
I wouldn’t swear that this information is correct but it’s my understanding so far-but as has been said over/over this is all so screwed up that it is difficult to get straight answer from anyone.
Thanks Chocolate ink. You’ve eased my mind a good bit. In the flyers her insurance sent her it said if she wanted to keep it then do nothing about the Medicare d plan. I was just worried she might loose it.
By the way how have you been lately? I was going to comment the other day when you were talking about your migraines. I’ve had them for 20 years and I know exactly where you are. No one can really understand how bad it is unless they’ve been there. Hope you’re doing better and thanks again for the info.
I am beginning to think that people like us (dualies who are internet/computer literate) might know more about Medicare D than others…that is a shame, especially when you consider the number of people who are now in Medicare D who have never touched a computer.
Street Kid & Chocolate ink – I want to say thank you again for your help yesterday. I still have a few hairs left after pulling it out trying to find answers. I and the few remaining hairs on my head thank you.
And I believe you are right on the computer literacy. I printed out some of the horror stories about people who have been denied medicine and might be giving up their lifes because of this Medicare farce. I showed them to my Mom whom I was worried about with her insurance. She started crying after reading them. I told her you don’t see these stories on the news and you won’t. It’s worse than a shame or disgrace. It’s criminal.
I told her you don’t see these stories on the news and you won’t.
Fire off an LTE re: your mom’s situation…
Good idea. I think I will.
link to Roll call for Medicare D included in diary.
I’m sorry Street Kid – you’ve lost me here somewhere.
Check how your congresscritter voted and include that in your LTE!
Thanks – I kept going over the diary and was reading too fast. I finally figured out what you meant. Duh 😉
So far, I’m ok, as I am not on Medicaid, only Medicare, and the old drug discount card still worked this month,(and they tell me it will until I sign up with a plan, as long as I do by May 15th. We’ll see.)
BUT,I am surrounded by seniors who ARE also on Medicaid, and caught up in this incredible mess..some of whom are going without meds, so I have been trying to help some of them out. (They had people come here to explain all of this, but way too many folks just couldn’t follow the presentation. It took all I had to make sense out of it, even being a former RN case manager who has dealt with Meciare/Medicaid for years.
Even with this background I am still not able to fully understand the complexities of many of the cases I am seeing here. Phone calls for “accurate informration” are a waste of time, for you get different answer from each so called reliable source, to way nothing of the hourse spent on hold.”
In the last senior apartment building I lived in, (subsidized housing for the elderly and/or disabled) we ended up operating a sort of underground pharmacy, hoarding up unused prescriptions, donated by people who’s doc changed had changed their scripts…so they could be used by folks whose docs had prescribed the exact same drug and dosage, but who couldn’t afford to buy their own supply. Yes, I was well aware that for me as a professional, it meant risking a felony charge and loss of my license to practice. But worth it, over seeing one more person being hauled out of there feet first, from a stroke they didn’t have to have sustained if they had had blood pressure medications as prescribed.
For so many of the elderly and disabled, this system can only be described as a living hell, and that only for as long as they can figure out how to stay alive, in spite of it.
“My country ’tis of the..sweet land of..liberty?”
I am not singing….
(in too much of a hurry and too mad to spellcheck.)
I have that same problem. The message was more important than correct spelling by my book.
Agreed!
And thanks for FPing this, Steven–this one has to get out!
For people who are having difficulty getting their rx’s: call your congresscritters and Senators, and raise hell. (Roll call linked to in diary.) Start the LTE’s. Threaten to call the papers if a person is not getting rx’s. And if congresscritters/Senators start to give someone the runaround, then DO IT! (Assuming everyone is comfortable w/that.)
Thank you, DF!!!!!!!!!!!!!!!!!!
Bush made his executive order for giving people a 30 day supply of medicine at a low price, to “tide people over” until this snafu gets straightened out.
of course, it will take much longer than 30 days for this to be in anything like a functional working system. So even if your relatives got medicine via the Bush order for right now, the time will pass very quickly for this months supply and they may be right back in the middle of a morrass.
My husband and I take more meds than I like, and everytime we have picked up medicine recently, the confusion at the drugstore is obvious, and getting worse.
At a time when there are problems on so many fronts, we have to take care of our families and friends who need our personal help, and our political pressure, too.
of course, it will take much longer than 30 days for this to be in anything like a functional working system. So even if your relatives got medicine via the Bush order for right now, the time will pass very quickly for this months supply and they may be right back in the middle of a morrass.
I wonder if what is going to happen at when the 30 days run out, as I also take rx’s and have Medicare D…