The President and States Step in As Confusion Occurs with New Medicare Part D Program

January 16th 2006

Trouble getting medications

It has been reported that tens of thousands of Medicare recipients have been unable to get their medication under the new Part D program. The Bush administration has stepped in telling insurers that they must provide a 30-day supply of any drug their beneficiary has been taking. Also, if a beneficiary is poor, they may not be charged more than $5 for brand named drugs and $2 for generics.

Some states have declared public health emergencies. Certain states have even stepped up to the plate saying they would pay for prescriptions that should be covered by the federal Medicare program.

The program has been frustrating for many pharmacists. The vast majority of beneficiaries have been covered, but there have been glitches. There are reports of insurance companies being swamped with phone calls.

According to an article published in the Detroit News, there are thousands of Michigan's poor and mentally ill having trouble getting vital medications. It is feared that patients with the most severe psychiatric disorders are at risk of losing access to medications that will help keep them off the streets or out of institutions.

Some blame the insurers for not covering drugs they said they would. There was a lot of confusion over the new Part D plan because different plans cover different drugs. Recipients need to make sure that their plan specifically covers their drugs, and not just pick the one with the lowest co-pay or deductible.

Since the Medicare plan took effect on January 1st, some patients have had trouble filling their prescriptions. Please visit our special Medicare / Insurance section for more information.

This is a comment we received concerning this article:

I am a senior who has his part "D" and "NO" part "D" problems.

I would like you to consider the other side of this problem.

First, Soc. Sec. sent out a pamphlet in June-July-2005. In that pamphlet it was explained to all who received it that in order for this program to work, even for the "dual-eligable" senior or disabled on medicare that 2 things needed to be done.

1. Tear out the "Extra Help" application. Fill it out and send it in with the enclosed envelope to Soc. Sec.

2. Contact your local senior center who will help you enroll in a plan.

3. Go to your local pharmacy in January and begin collecting your benefit.

It seems that about 99% of the seniors and dual-eligible people did nothing more than take action on instruction number 3.

I really believe that there is more fault here than the one side being blamed for this problem.

It's a FREE country!! I got my Rights!! Yes, you do but with FREEDOM comes responsibility for your actions which I believe that you didn't bother to do or this problem would not be out there today I am sure.

I would appreciate you taking the other side of this issue on as well as the Governments side which is getting all the blame here that is really not warranted with this mess and the Government being blamed as the only one at fault here.

As far as the pharmacist's here. they deserve a "purple heart" !! They took enough fire on this issue to last a lifetime and were totally innocent.

I am retired and have been available every Monday morning for the last 3 years at the local senior center with computer online and available. I have done over 300 people since June 2005. Guess what, I have had -0- complaints since Jan.1. The monthly general meeting was Wed. Jan. 11th. I was met with nothing but thank you's from all who attended.

Please show the issue from both sides.

Bob Mills

Redding, Ca. Contact Bob