Medicare Part D

[elfs]

Yesterday, I tried to talk to my insurer about an issue, and when I called I got the following message: "Due to changes in Medicare Part D, we are experiencing unusually high call volumes. Your wait is currently one hour, forty-five minutes."

Today, when I stopped by the drug store to pick something up for Omaha, the pharmacist was wearing a headset (and this is a very, very traditional kind of guy; a radio headset just does not look right on him) and he was talking to some poor woman about all the different Part D plans and what they could do for her, and he had absolutely no time for the people in line. Fortunately, most of the business could be handled by his technicians, but he was obviously already stressed out, and it was early yet in the morning.

Comments

Part D is an impossible mess

[shunra.livejournal.com]

I had to research it for an article for my local newspaper, and ended up with my brain tied in knots (and no article).

The way it seems to work is that each of the many "plans" that the medicare patients have to choose from - and they must sign up for them as soon as the CAN sign up for them, on pain of greatly increased fees in the future - covers only a particular mix of drugs. So when trying to figure out which plan to join, the (elderly) person must make a guess: which plan will cover the most drugs that they use now and are likely to use within the next year.

Penalty for making an incorrect guess? Healthcare becomes unaffordable.

The rules allow "plan-hopping" only once a year.

Can the possibility of guessing wrong and choosing the wrong plan, thereby eating up in pharmaceuticals all of one's food, eating, and medical budget, be leading seniors to panic? And that's only if they've gone through the confusing literature and *understand* how crucial their guess about which plan to join is. Many don't understand the system and all and are just plain panicked.

Oh, and to add to this mess, doctors aren't informed enough about the different drugs covered by the different plans. They don't know enough about which plans carry which drugs, and can indavertantly cause huge financial damage by prescribing the wrong kind.

It is a mess. The only winners I can see are the plans themselves, which have a captive audience of uneducated insured persons.

You know it's bad when...

[ladyallyn.livejournal.com]

It has the people in medical admin who deal with things like this every day completely confuddled. I feel for both the providers who are trying to explain tings and the poor seniors who got into insurance when the only options were straight indemnity 80/20 or essentially pre-paid (commercial socialized - such an oxymoron). Other than that it was pay as you go.

It says bad things about the state of medical practices when you have twice as many admin/clerical/billing staff as people who provide clinical patient care (as is the case in my group, unfortunately).

(waves hi, BTW)

You're Not Kidding About It Being A Mess

[(Anonymous)]

My sister was placed on Medicare due to kidney failure at the age of 23 six years ago. They have randomly assigned her to one plan developed for elderly people and the costs of it are outrageous. According to the new plan, she would need to pay $20 for each refill of a generic prescription and then pay 25% of the cost of a brand name drug. Unfortunately, since she is a kidney dialysis patient, she has a) a ton of drugs, b) a great majority of these drugs do NOT have generics so she has to get the brand name, and c) she is unable to work because she is 100% disabled. Thus, the little amount (couple of hundred) that she gets in Social Security per month would go directly to paying her drugs levaing nothing left for rent, food, etc.. So far, the only way she has been surviving is that she still lives with our parents and I supplement her income every two weeks with my paycheck. The federal government SUCKS big time!