The new Medicare prescription drug program began a little more than two weeks ago, and pharmacists and beneficiaries are still scratching their heads.
“It’s been a nightmare,” Osco Drug pharmacist Barbara Bridges said.
The new program, which started Jan. 1 , is touted by the Bush administration as a way to provide low-cost drugs for all seniors and Americans with low-income jobs. So far the program has left many seniors struggling to receive the same benefits they got before.
Representatives and employees for Walgreens, 2100 Green Bay Road; Osco Drug, 1128 Chicago Ave.; and CVS/Pharmacy, 1711 Sherman Ave.; reported complications arising from the drug program. Many problems also come up with people who are dual eligible, or those who qualify for both Medicare and Medicaid. More than six million dual-eligibles in the country will receive coverage from the new program. Dual-eligibles, the group of beneficiaries with the lowest incomes, are required to bring additional verification – cards for both services – to their pharmacists, although representatives from Walgreens and Osco said this fact is often overlooked and adds to confusion.
Last week the Illinois Department of Healthcare and Family Services stepped in to help. The state will cover costs incurred by the patient in instances where a prescription drug plan cannot be identified quickly and seek reimbursement from the provider later. A number of other states have similar programs.
Entering every beneficiary’s information into a computerized system is a “monumental” task, Bridges said. Although most Medicare patients have known about the changes since 2005, they are still unaware of the intricacies involved in choosing a drug plan and getting the medication.
Pharmacies are getting the drugs to the people, but the process is daunting, Bridges said. Last week she said she spent more than four hours on the phone filling a prescription.
“There are people who returned their information in December, and for whatever reason, just weren’t put into the system,” Bridges said.
Patients are given a three-day supply of their drugs in cases where an Osco pharmacist cannot locate their information in the database, she said.
Still, there have been enough snafus to keep Medicare recipient Mary Ann Murphey, a 69-year-old Evanston resident, from signing up.
“There are just too many problems with the system, and what I resent is that (the government) is getting people hysterical,” Murphey said.
For now Murphey can afford to do without the Medicare prescription drug program. She receives her medication through a supplementary insurer. She has until May 15 to switch to the Medicare program for 2006 coverage. After that, she faces penalties.
Pharmacies and beneficiaries aren’t alone in their battle to explain and understand the new program. Counselors at Evanston-Skokie Valley Senior Services are getting many questions about how to choose a prescription plan that works.
“This has been a process geared toward seniors who can spend the time and understand the complicated process,” Program Supervisor Danielle Clemens said.
For those who lack time or Internet access, the process is a maze. Much of the information is online, Clemens said. And those who call often are misinformed about what information is valuable, versus what information is discardable. Most remain calm throughout the process, but some panic because they don’t understand which program is best, she said.
And because the deadline to change over is in May, complications and questions will spike again as seniors like Murphey change their plans just before that date.
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