Medicare confusion keeps seniors from drugs

[Thom Little]

Despite the months-long help and preparation seniors received for the new Medicare drug plan, some of them are having trouble filling their prescriptions.

Some seniors have had to drive to a different pharmacy or pay more for what they need. Others are going without their medications.

“I have people without Oxycontin today, I have people without insulin, people without cardiac drugs,” said Carolyn Virtue, administrator for Heritage Case Management, a company that serves 500 elderly and chronically ill clients across New Hampshire. “These are life-saving drugs.”

.......

Virtue said the problem seems centered on seniors who receive home health-care services through Medicaid, a program that uses state, federal and county money to pay health and long-term care costs for the poor. In the past, Medicaid covered their prescription drugs, but they have been shifted to the federal Medicare program.



http://www.theunionleader.com/article.aspx?headline=Medicare+confusion+keeps+seniors+from+drugs&articleId=da2d66d5-f4e1-4f7b-bd43-b271c347ae65

[Rainscents]

1. Welcome to Bush country!

His only goal is to make sure, seniors and poor die off. :sarcasm:

[barbaraann]

2. Hitler used gas chambers, the GOP uses twisted legislation.

They probably sit around laughing about how many seniors they kill off every day like the Enron traders joked about Grandma Millie during the energy crisis.

I wish that human beings were running the federal government. :-(

[demnan]

3. My Mom called to thank me today

for helping her figure out her benefits. We called AARP and spent hours trying to figure the whole thing out. Now her benefits are the same as before. She only pays $3 and something a month for her prescriptions.

However, I lost my job and have no health benefits and had to pay $31 for cough syrup for a prescription refill.

If the seniors have it bad, what about everybody else out there in the no health care market?

[Casandra]

4. Just dealt with this..

Earlier today, I wrote a thread on this topic. I've figured out what has happened and wanted to warn everyone having relatives or they themselves being affected.

Where this program was touted as voluntary, it is NOT! The feds put the pressure on all the HMO's, that they HAD to convert to this medicare part D program or lose their funding. Thus, all seniors were forced onto this plan for their meds. Any supplemental programs for co-pays etc. are now pulling out, leaving the whole thing to Medicare Part D.. We're now talking (here in California) co-pays of approx $40 per RX..

Been on the phone, on the internet...everywhere I can, hollering about this..Better check your own plans..and now!

[Lars39]

5. I thought I had my dad signed up before Christmas,

with his coverage going to kick in by Jan. 1st, 'cause he signed up on-line. They had absolutely no record that he had been there, except for sending him more info about all their programs. I chewed ass on tape, but the bottom line was that "the holidays interfered" with getting the proper info to him. :grr:

He's got the money for this month's prescriptions, so it was more aggravating than anything.
I am furious on behalf of every senior having to deal with this bullshit.

[mom cat]

6. It is a nightmare. I had to print out a copy of the law and take it to the

pharmacy today in order to get what I needed. The Medicare RX carrier had screwed up my account, but I could not get through to them to straighten things out.They have quit answering their phones. They are not even talking to the pharmacists!
These companies are making big bucks off of this deal and they couldn't even hire call centers in India to deal with the confusion they knew that was coming.
This is major FUBAR.

[Megahurtz]

7. More genocide. n/t

[DuaneBidoux]

8. Instead of a simple single provider (Uncle Sam) we get this shit which

does nothing but confuses the old and enriches the pharma companies.

[VegasWolf]

9. Hey, I just order my drugs from Canada. It's still way cheaper than

the costs the US Government Medicare plan allow for. And all with no bureaucratic paperwork required.

[sarcasmo]

10. Kick and Nom. The shit is gonna hit the fan over this new drug plan.

[Bobbieo]

11. New Drug Plan and Srs. - Just discovered I have an aortic aneurysm -

Up to now prescription drug costs have been at a minimum and get my blood pressure meds in Baja California - but with this new disclosure looks like I'm in for some changes. Have to take another set of x-rays or whatever and see the surgeon on the Jan 16th. Up to now, I had to intention of signing up for the new drug plan - What's with this penalty after May 15th crap????

[bobbieinok]

12. I think....if you sign up for medicare prescription after May, you pay a

penalty for each month you could have signed up and didn't

[Bobbieo]

13. Drug Plan and Srs - Hopefully I'll drop dead

before May 15th - If I never use the expensive drugs I still have to pay the yearly deductible - right? Screw that plan!!!!It's sort of like buying veterinary hospital insurance when you have no intention of getting a pet.

[phoebe]

14. considering Mark McLellan (yes..Scott's brother) is in a position

of power in Medicare/Medicaid why should you be surprised..yet more croneyism..

http://en.wikipedia.org/wiki/Scott_mclellan

snip


McClellan is the son of Carole Keeton Strayhorn and Barr McClellan, an attorney who wrote "Blood, Money & Power: How L.B.J. Killed J.F.K." McClellan's brother is Mark McClellan, who is currently head of the Centers for Medicare & Medicaid Services.

[cosmicdot]

15. **'s pay one of his corporate buddies to pimp your drugs program

gotta pay one of his corporate insurance firms a monthly amount which could range from $5 to $50 just to get some so-called discount (off-set by escalating Rx prices) ... and, that penalty business ... suppose one doesn't need an insurance pimp now but things change after May 2006?

one might end up paying more than one's monthly Rx cost by having to pay a monthly premium

I suspect the changes have had an impact on pharmacy and doctor's record/transaction systems ... the pharmacy system will have to keep track of yearly accumulative tabs for each customer and each customer's insurance plan

sample plan:
a deductible for the first, say, $250 of Rx costs.
Then, one pays 25% of the Rx costs up to $2250.
After that level is reached, one pays 100% for the next $2850 in Rx bills;
then, out of pocket reverts to 5% (or some co-payment) to year end.

and, then, there's something called Medicare Advantage Plans which as far I can surmise is outsourcing Medicare on the individual level ... systems have to be designed to accommodate them, too.

in this neck of the wood, there are something like 47 different options (some insurance companies had up to 3 options)

All that is needed is Medicare involved in working with Big Pharma and one's Medicare card to show the pharmacist.

edited to add:



Senate passes Medicare bill

Tuesday, November 25, 2003 Posted: 9:16 PM EST (0216 GMT)


WASHINGTON (CNN) -- After days of impassioned debate, the U.S. Senate Tuesday approved a $400 billion plan to overhaul Medicare. Supporters say it will give prescription drug coverage to 40 million older Americans, while critics warn that it could destroy the system.

The 54 to 44 vote was not along party lines -- 11 Democrats voted in favor and nine Republicans voted no.

~snip~

Supporters of the bill -- including some Democrats who, like Sen. Dianne Feinstein of California, said it was better than no bill at all -- hailed the vote as a victory for senior citizens

~snip~

The House passed the bill in a controversial vote early Saturday after late-night phone calls from the president, a move credited with helping get the bill passed there. A three-hour vote was ended by GOP leaders at 6 a.m., after a 218 to 216 deficit flipped to a 220 to 215 victory.

http://www.cnn.com/2003/ALLPOLITICS/11/25/elec04.medicare/


Senate Roll-call Vote:

http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=108&session=1&vote=00459

voting for the Bu$h bill - it could have been defeated, especially with 9
Republicans voting against it!

Baucus (D-MT)
Breaux (D-LA)
Carper (D-DE)
Conrad (D-ND)
Dorgan (D-ND)
Feinstein (D-CA)
Landrieu (D-LA)
Lincoln (D-AR)
Miller (D-GA)
Nelson (D-NE)
Wyden (D-OR)

Not Voting - 2
Kerry (D-MA)
Lieberman (D-CT)

http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=108&session=1&vote=00459