Posted: 1/17/06
Medicare Part D: lots of glitches, but things will get better, pharmacists say
By David Heiller
Argus News Editor
Keep a positive attitude. In the long run, everything will be OK.
Thatís the big picture that pharmacist Tom Witt would like senior citizens to keep in mind regarding Medicare Part D.
The new prescription drug plan that began January 1 has had some growing pains.
Wrong information or sometimes no information, long waits on the telephone, and confusion at the pharmacy counter are some of the most often heard complaints.
Mary Jane Hendel of Caledonia has experienced some of those things with Medicare Part D. She called the program a mess.
Hendel, 74, said on January 11 that she had gone to Wittís Pharmacy in Caledonia five days earlier with a list of medications, a copy of her supplemental insurance policy, and the date the medications were running out. The order was untouched when she went back after five days.
Wittís was able to fill her three blood pressure prescriptions, but in the conventional way and not through Medicare Part D.
ěI do not blame the pharmacy,î Hendel said, a point she repeated several times during a 10 minute conversation. ěI think theyíve given excellent service.î
Hendel feels people need to take responsibility for their own health. ěBut dog-gone it, you know,î she added, which from Mary Jane is tantamount to a string of words from your average longshoreman.
She also feels bad for people not able to figure out what they need to do or who are unable to get to the pharmacy like she can.
Perhaps that is why pharmacists like Tom Witt are urging patience. Witt owns drug stores in Caledonia, Spring Grove, Houston, and Rushford, as well as a closed-door one that serves nursing homes.
He did presentations to senior citizens late last year, and picked up a lot of confusion on the part of senior citizens. People were afraid of being scammed, or of not picking the right plan, he said.
Not to worry, Witt said. ěThereís benefits to this plan, they just have to work with somebody that tries to be objective with them.î
Yes, there are glitches, Witt said, but they were expected, and pharmacists are try hard to make it all work. ěThe first three months are going to be problems,î he said.
No seniors have been denied their needed medicine, Witt added. Thatís the nature of small towns where pharmacists know their patients, although he has heard of such occurrences in bigger cities. Prescriptions are given out a week at a time until the glitches in Medicare Part D are worked out, Witt said.
ěLike I said, weíre going to keep a positive attitude and make sure the patient gets a weekís worth of stuff.î
Getting answers is not easy
Both Witt and fellow Caledonia pharmacist Rick Sime of Caledonia Drugs have faced some hurdles with getting answers from Medicare part D workers.
ěIíve had people on hold for up to an hour and a half before they get an answer,î Witt said. The pharmacists just put the phone on speaker phone and keep working until the call goes through.
Pharmacists use what is called an e-system, which was supposed to be set up with the patientís name, address and social security number. In return pharmacists were to receive the insurance plan, identification number, and how to transmit claims. This didnít work well the first week, Witt said, and while things have improved, he feels it will still take time to get it up and running.
Sime gave an example of a case in which he had to call Medicare three times. Twice they could not figure out the problem. The third time, after a 45 minute wait, Sime determined the problem. ěThey had the personís birthday in the system wrong,î he said. Once that was fixed, the order went through.
Many patients havenít received confirmation letters or insurance cards from Medicare, Sime added.
He has had to modify his computer program too, adding places to enter bin numbers and routing information. ěNone of this information was provided to us prior to our starting,î he said. ěWe had to make up new billing information for each of the plans.î
Sime called the situation a real challenge. He said he expected some rough spots, but not nearly as many as there are. And like Tom Witt, he said calling the processors for information is almost impossible.
Medical assistance issues
Other problems have arisen for people on Medical Assistance, Sime said. These people were automatically enrolled in a plan, and pharmacies had no clue what those plans were until the people showed up, Sime said.
ěSome of the companies we were assigned we had never heard of,î he said. Sime feels there should be a way to put this information on-line to see where these patients have been assigned.
People who are on assistance have enrolled in Minnesota Senior Health Options (MSHO), said Bonnie Goetzinger, Houston County financial assistance supervisor. They have had some problems with pharmacists who didnít enroll with every health plan, she said.
Goetzinger said that the main problem is that all of the plans do not pay for all of the same drugs. Seniors have to make sure before they buy a plan that the pharmacist accepts the plan, she said.
People need to go to their pharmacy with a list of medications and see which plan works for them, Goetzinger recommended. ěPharmacists have been very helpful in determining which plan will pay for which prescription,î she said.
County financial worker Lori Feldmeier added that part of the problem is that cards are being issued with incorrect information. Older people are shaken up by this, she said, because they donít think theyíll get their drugs. It ends up being a computer problem, and people can call the companies and tell them what needs to put in the computer. ěNinety-nine percent of the time it goes through and weíve got the problem solved,î Feldmeier said.
She also recommended a senior linkage line as a helpful resource with independent advice. The number is 1-800-333-2433.
Things will improve, Rick Sime feels. ěThe kinks will get worked out.î He estimated that by March, it will be going well. A lot of people waited until the end of December to sign up, which has caused some of the delays.
Is Medicare part D a good program? ěAs far as helping people out, I think it will be a positive in that sense,î Sime answered.
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