Sunday, January 15, 2006

MEDICAID PLAN D DRUG PLAN IS A MESS!!!

For the past several weeks, I have been working as a Member Services Representative for a company that provides the new Medicaid Part D Prescription Drug Plan which began January 1. And let me say that the headline above does not even begin to describe the situation that seniors and low income Americans are facing with this programme.

In some cases, the individuals who will be receiving the assistance through this plan did not bother to read the yellow letter sent in November from the federal Department of Health and Human Services advising them that their drug benefits would be changing. Some, believing it was simply another piece of junk mail, threw it away and didn't bother reading the important information within.

But the Centers for Medicaid and Medicare Services (CMS), the federal agency that is coordinating this plan, really screwed things up. In a number of cases, those people who did sign up through Medicaid did not have their information transferred to the various companies providing the Plan D service for their area. Thus, they were/are not in the system, and cannot get their medications through the programme. As a result, some states are stepping in to assist until things are corrected.

Also, reciepents are not being advised that it works much like a HMO in that they cannot necessairly use the pharmacy they want; they have to deal with one contracted with that provider's network. In the case of the company I represent, many of the major national chains are included. But that doesn't help recipents who have been using a small, independent pharmacy for years that may not have signed on to our network. They have to change.

It's really sad to hear elderly and poor people, literally, weeping and in hysterics over their inability to get medication necessary in some cases to sustain life because the government screwed up. The programme is confusing: For the providers, for the pharmacies, for the recepients, and for those of us who have to answer the questions they ask. Let's hope they all get their act together really soon.

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