I am frankly tired of talking about and reading about Medicare Part D, the prescription drug program. If I were a betting woman, and had a lot of money, I’d be likely to bet against the success of this program.
Willing to believe that those in power who make all the rules, actually knew what they were doing, I went along with the program, filling out forms, answering questions and following advice after thoughtful consideration.
Since everything requested to be done had been done and in a timely manner, I naturally thought getting a prescription filled after Jan. 1 would be a piece of cake.
Prior to Medicare Part D, the state had a program loosely called DEL (Drugs for Elderly) under which I qualified. It was clear from the letter I received from the state, that “they” would choose a drug insurance company for me, “they” would assist in payment, and all I had to do was show the letter to my pharmacist.
So I called in a prescription renewal and went to the drugstore to pick it up and the pharmacist asked to see my insurance card. I showed them the letter, as instructed, and was told I still needed a card.
What to do?
Since the purpose of this particular heart medication is to help prevent strokes, I had no choice. I paid for the prescription in good old cash. Fortunately, this generic prescription cost only $26, but that’s a lot different than the $4 which I’d been paying under the prior state program.
When I called the state’s pharmacy hot-line and told them I hadn’t received my insurance card and had to pay full price, I was asked, “Why did you do that? You didn’t pay them, did you?” Well, yes I did. I told this person that the drugstore couldn’t find me “listed” even though the state told me I would be covered. So, yes, I paid for the drug. I do want to continue hearing my heart beat.
The state authority said that the insurance company they had chosen for me would “probably” be sending cards and I should be receiving one. That’s not real encouraging.
Later that day, I got a letter from the insurance company that the state “picked.” This letter, dated Jan. 7, told me my enrollment would be effective Jan. 1, and as of that date I should begin using the insurance company’s network pharmacies. (I had to call the insurance company to get a list of these pharmacies in my area.)
The letter continued that “When CMS (Center for Medicare and Medicaid Services) approves” my enrollment into the insurance company, I would receive a letter of confirmation. BUT, I was advised, “Don’t wait for the confirmation letter before beginning to use the network pharmacies on Jan. 1”
Huh?
In other words, the state chooses an insurance company, which the state will reimburse, but the feds need to approve it before it’s confirmed. If the feds don’t approve the enrollment, “you will be billed for any prescriptions you receive through us.”
If this sounds like a mess, you’re correct. I hope that no one in government was depending on this program to secure votes for political office. I cannot imagine how many people have been hired to work on this poorly planned program. And worse, I think of the thousands affected by this and how very difficult it must be for them to wade through all the misleading and confusing paperwork.
I hope by next month, when I again go to the drugstore for refills, the feds, state and the insurance company have gotten their act together and issued insurance cards.
This latest government program, dreamed up by people whose future insurance plans are in place, generously paid for by our taxes, just makes this senior citizen more apprehensive than ever about trusting our political leaders.
I’d love to hear from other seniors as to how this program is working for them. Am I in the minority?
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