Medicare change causing confusion

~ Problems are arising from people unsure about exactly what is covered under the new plans.

In the first week of the nationwide switch-over to Medicare Part D prescription drug coverage, local pharmacies are reporting chaos and confusion from seniors unsure about their new plans.

"It's a nightmare," said Gene Brockett, manager of Jones Drug Store. "Yesterday we spent 30 man-hours -- I counted it up -- between eight employees on the phone, waiting on hold from insurance companies and faxing doctors insurance information."

Seventeen insurance companies are offering 42 prescription drug plans nationwide in a program that has promised to save thousands of dollars annually for some people.

Pharmacists report that a large source of their problems comes from a failure of insurance companies to send patients a new insurance card in time for the Jan. 1 change. These patients, many of whom depend on regular prescription refills, are then left paying out of pocket for prescriptions with the promise of being reimbursed somewhere down the line.

"People are pulling their hair out and cussing, they're raising hell," said pharmacist Carroll Snead of Broadway Prescription. "Some have letters, some have cards, some don't have anything, so they're not getting their prescriptions filled because of snafus between the insurance companies. If you ask me, the insurance companies are not working for the people; they're working to make money. Some are good and some are horrible."

Deb Wiethop of Blue Cross and Blue Shield of Missouri said the number of seniors calling in has been overwhelming.

"The same thing has been true of all carriers," she said. "We have run into difficulties and we have been overwhelmed. We understand that some people have not received their cards, but they are coming, they're in the mail. It's a new program and we're still figuring things out."

Problems are also arising from people unsure about exactly what is and is not covered under the new plans.

"We've had several people come in here for their insulin," said Brockett. "Now insulin is over-the-counter in Missouri and on some of these new policies people are finding out that it's not covered. So we've been sending them away with one bottle and hoping they get it straightened out before they come back, we're doing everything we can."

For some, the array of choices and the difficult language of these plans pose unforeseen problems.

"I've seen people who brought in those books," said Snead of the literature sent by Medicare to explain coverage options. "And there is just no way people are going to understand it. It's all in government language and you need a lawyer to figure it out."

An estimated 21 million people signed up to use the new drug plans. The U.S. Department of Health and Human Services expects that number to increase to 28 million when the initial enrollment period ends on May 15.

tgreaney@semissourian.com

335-6611, extension 245