Progress Pond

Medicare D(isaster): Choice Time Again!!!!

Ambulances parked in front of the U.S. Capitol Building in Washington DC.

NYT:

Retirees and dual eligilbes who are enrolled in more than one Medicare D(isaster) plan now have to choose the plan that they wish to remain in.  Notices, on green paper, are being sent to those who are enrolled in more than one plan.  Supposedly, this will assist in clearing up any confusion due to dual-enrollment.  However, many dual-eligibles have discovered that they have been enrolled in two plans, if they have made the decision to change the original plan that they were assigned to.

“There appears to be a fundamental flaw in the Medicare computer system that transmits information on enrollment of clients and their low-income status. We have clients who changed plans last November. The first plan has information on their low-income status, but the second plan still does not have the information.”

continued below

The letters, being sent by private insurance companies on government letterhead, say, “The purpose of this notice is to confirm your choice of a Medicare prescription drug plan and to ensure that you are enrolled in the plan you want.”

Beneficiaries who take no action will be removed from the rolls of the plan to which they were originally assigned, but they will still have coverage under the second plan.

 That is, assuming that the second plan covers their rx’s.

People have the option of staying in their original plan, but must indicate that desire by calling that insurer. Otherwise, the letter says, “you will no longer be able to use your membership card.”

 Seems like this could be another way to decrease coverage for those who need it most.

Approximately six million low-income people entitled to both Medicaid and Medicare were assigned to Medicare drug plans selected at random, as opposed to a plan that would cover all of their rx’s.

Stan Rosenstein, the Medicaid director in California, predicted that the change would be “very confusing” to many beneficiaries.

“We try to reach people in 12 languages, and even then it’s difficult.”

As a result, many are having two premiums deducted from their SS checks, and are still unable to afford their rx’s, rent, utilities, and/or food!   In addition, there was an instance reported (also by the NYT) that a plan did not want to let a beneficiary change to a different one, detailed here.  

And, as diaried by nyceve,
the co-pays are increasing, as are the prices of the rx’s, if they are, in fact, still being covered.  As stated earlier, by  independent pharmacist, David Olig, “”In the retail world they call that bait and switch.”  Olig further stated that he was afraid of something like this happenning.  This underhanded tactic is denying people the rx’s that they need to stay alive, in many, if not most instances.

Sixty-one percent of pharmacists said customers’ “formularies” had changed after they signed up. In two-thirds of cases, the changes were not beneficial to consumers.

Now, after realizing that the costs of the co-pays can change at big rx and an insurace companies will, as can the rx’s that are covered, is there any doubt that Medicare D(isaster) was “was written by and for big drug companies and H.M.O.’s, not American families.”?  

In a nutshell, the searching for the right plan for a person is starting all over again, with a timeline of May 15 to enroll, w/o paying a penalty.  Now, how are those who are not computer literate going to manage to go thru the “updated” Medicare D(isaster) website?  Or should they wait for Medicare Bus to make a stop in their town?  Or, is talking to a WalMart pharmacist an alternative?  What about contacting the AARP and purchasing the United Plan?

The fact of the matter is that people need to get their rx’s.  I know for a fact that I am not the only one who is dreading calling my pharmacy next month to get my rx’s refilled.  Only thing that I can suggest is for others in that same situation is to find out as much as  they can in advance, be ready for a battle, and don’t be shy about contacting the media or congresscritters to raise holy hell about this.

I am also making another request for others to start cranking out the ltes and contacting all congresscritters on behalf of those who are unable to do so.

My first collection of diaries are linked to inMedicare D(isaster):  Action Needed!!!

The second diary w/links is, simply titled, Second Request for Advocacy.

Others that have been written since then are:  More Medicare D(isaster) Limitations, Need Refills?  April Fool!, Medicare D(isaster):  Angry Opinions, and Medicare D(isaster):  More Money….

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