Article compiled from The Washington Post

Harold Meyerson’s Jan. 25 op-ed called Medicare Part D a “mind-boggling failure.”

This program has been in effect barely a month. The transition is not without problems, but it is not the disaster that Mr. Meyerson described.

Medicare is responding to many of the initial program glitches by issuing guidance to plans and pharmacies on transition policies. It has increased the number of customer service representatives and encouraged the plans to do the same. The Centers for Medicare and Medicaid Services (CMS) has announced how it intends to reimburse the states that have picked up the tab for those who fell through the cracks. CMS also has caseworkers finding solutions so that beneficiaries can get their medications.

The Medicare Rx Education Network, a coalition of 79 organizations, is working with CMS on identifying and addressing problems and on education and outreach.

Most people are getting their prescriptions. In fact, more than 1 million prescriptions are being filled every day under the program. More than 3.6 million people have signed up for the drug benefit, and 20,000 more are enrolling daily online.

Although its off to a bumpy start, I’m confident once the bugs get fixed, the new Medicare Part D will be successful.

Story and following information found at The LA Times:

I was defeated by the new Medicare drug program.

The weapon used against me was Medicare’s “plan finder,” a website that churns out a list of private Medicare drug plans, along with their estimated annual costs, based on the prescriptions the user types in. The website then prompts the user to enroll in the plan that best suits his or her medical and financial profile.

Unfortunately, the system is burdened by numerous peculiarities and complexities that render it almost useless for millions of potential beneficiaries. The most serious drawback is the one that snagged me: While the program bases its calculations of prescription costs on a “30-day supply” of each drug, for those taken orally it assumes that a 30-day supply is 30 pills.

But many medications aren’t taken once a day. Unless the user manually overrides the 30-pill default, the result can be wildly misleading.

When I tested the system for a column last month, I typed in Actonel, an osteoporosis drug commonly prescribed for patients over 65. Actonel is taken once a week. Therefore, the 30-pill default overestimated its monthly cost sevenfold, hopelessly contaminating the results. How hopelessly? Of the 48 health plans available to California residents, the one it ranked as the least expensive was really the 37th most expensive when the correct dosage was entered. Any unassuming or inexperienced customer therefore risked being steered to the wrong plan.

This glitch isn’t exactly a secret. Medicare authorities were alerted to it in November by drug manufacturers concerned that it could make their products seem unaffordable. (The error also understates the cost of a medication taken several times a day, such as many diabetes treatments. That could steer beneficiaries to the wrong plans, too.) In response, Medicare’s web designers added a note prompting users to double-check the quantities of their pills when entering prescriptions. But the notice can be easily overlooked amid all the other verbiage cluttering the screen — especially by people navigating the system for the first time.

Seeing as though the website is designed to be a prime source of information for seniors eligible for medicare, this problem in the system could prove to be very costly to those who choose the wrong plan due to the glitch.

I found this on Bloomberg:

Older Americans who wait until after May 15 to enroll in the U.S. Medicare drug plan may have to pay extra fees for the rest of their lives, said consumer advocacy groups seeking to extend the deadline.

Under a 2003 law, the premium costs that Americans pay to receive the new coverage will rise 1 percent for each month they delay enrolling after the May deadline. Those who enroll a year late will pay 12 percent more for as long as they’re in Medicare, the U.S. health insurance plan for the elderly and disabled. The law doesn’t set an expiration date.

The deadline pressures senior citizens already complaining about the dozens of new drug plans offered under the program by insurance companies including WellPoint Inc. and UnitedHealth Group Inc. Democratic Senator Ron Wyden of Oregon today pressed Medicare chief Mark McClellan to extend the deadline.

Republicans including Olympia Snowe of Maine, a finance committee member, have supported changing the deadline. Sixty votes are needed to change the rule. On Feb. 2, 52 senators voted in favor of extending the deadline, with one supporter, Democrat Jeff Bingaman of New Mexico, unable to make the vote.

It will be interesting to see how the vote turns out and, if the deadline is to be changed, when it will be.

From NPR:

aving failed to convince Congress to overhaul Social Security last year, President Bush in his budget for fiscal 2007 is taking on an even more politically difficult task — slowing the growth in Medicare.

The administration’s budget actually proposes cuts to a wide variety of health programs, including the Centers for Disease Control and Prevention and aid to children’s hospitals. It would freeze funding for many more, including the National Institutes of Health.

But the biggest money — and the biggest controversy — will surround efforts to reduce spending on Medicare, the federal health program for the elderly and disabled. The budget would reduce Medicare spending by just short of $36 billion over the next five years. But at the briefing to unveil his department’s budget, Health and Human Services Secretary Mike Leavitt said the cuts won’t even make that much of a dent in Medicare’s long-term financing shortfall. “They will amount to reducing our growth rate by less than 1.5 percent. Under the current pattern, we would see spending at 8.1 percent over the next five years. Under this proposal, it would fall to 7.7 percent. Medicare will continue to grow, but at a slower rate,” he said.

From the Detroit Free Press:

Thousands of Michiganders are running out of life-saving medicines after spending hours waiting on hold for help with their new Medicare prescription drug plans.

The drug coverage plan — the most monumental change in the Medicare program in 40 years — continues to be plagued by significant and widespread problems:

# Tens of thousands of Medicare patients nationwide have had problems filling their prescriptions, Medicare officials acknowledged Wednesday.

# Pharmacists can’t confirm patient eligibility through the national computer verification system.

# Insurers are denying coverage for medicines they once said they covered.

# Low-income seniors are being overcharged.

To top it off, Medicare members and pharmacists can’t get through on the phone to the people who are supposed to help when things go wrong.

The insurer help lines are overwhelmed, and most require patients to wait on hold at least 20 minutes before they connect to a customer representative. Some patients report significantly longer waits.

Insurance company Community Care Rx’s pharmacist help line informs callers that it’s overwhelmed and will disconnect in three seconds. Tick. Tick. Click.

Medicare beneficiary Audrey Roof of South Lyon said she’s waited on hold four times with Medicare and her insurance plan — 40 to 70 minutes each time — trying to straighten out her drug coverage. And her experience isn’t unique. We should know.

The Free Press called the customer service numbers at the 18 insurers that offer prescription drug plans in Michigan. Sure enough, one plan cut us off, two had busy signals, and 13 put us on hold. Only at PacifiCare and Cigna did we get through immediately to a customer service representative.

From the Seattle Times:

More than 2 million people have voluntarily enrolled for the new Medicare prescription-drug benefit in the past month, exceeding projections by the Bush administration.

Health and Human Services Secretary Mike Leavitt touted the enrollment numbers on Monday as good news for a program that has stumbled in the early going. About 20 states have been compelled to help pay for medicine that many senior citizens and the disabled could not get through their new coverage.

“The program is working for the vast majority of participants quite well,” Leavitt said.

Leavitt acknowledged that the program was not working for some. He said the administration was working feverishly to address concerns that tens of thousands of people who can least afford to go without their medication are struggling.

He said he would begin a tour on Wednesday of numerous states — Oregon, California, Texas, Arkansas, Florida and Wisconsin among them — “to find out how things are working in the field.”

The new drug benefit began on Jan. 1. About 42 million senior citizens and the disabled are eligible to enroll in private health plans that will subsidize their prescription-drug costs.

Last month, the administration announced that about 21 million people would get drug coverage through the program.

About 1 million of that group had voluntarily enrolled. The rest were automatically enrolled because of their participation in other programs, such as Medicaid.

Happy New Year! Medicare Part D is now in effect. I’m sure we’ll have plenty of news over the next few months as this concept gets put into practice.

I stumbled across this article in the Southwest Daily News. If you’re looking to learn about Medicare Part D, it’s a good place to start.

Enrollment for Medicare’s prescription drug coverage began on November 15th, but for many it may take until the deadline of May 15, 2006 to sort through all the jargon and choose the plan that best fits their needs.

The new program, known as Medicare Part D, will start January 1, 2006 for persons already enrolled in the plan. Enrollment will continue until May 15, 2006. Medicare will start covering subscribers’ drugs at the beginning of the month after enrollment in the Medicare drug plan. For example, if a person signs up for coverage on Jan. 15th, then coverage will start on Feb. 1st.

If a person does not want Medicare drug coverage, then sign up is not necessary. But be careful. If a person who is eligible misses the window of opportunity for sign-up, and later wants Medicare drug coverage, it may cost more.

People not yet on Medicare will be able to sign-up for drug coverage when they become eligible for Medicare at age 62.

The standard Medicare drug benefit offers insurance that will pay some drug expenses and will protect against very high costs. If one has additional drug coverage from an employer or a state pharmacy assistance program, then the out-of-pocket expense will be reduced.

Once enrolled in the Medicare prescription plan for 2006 a $250 deductible must be paid before drug coverage begins. After the deductible has been paid, the plan will cover 75 percent of the next $2,000 of drug cost, and the subscriber will pay the remaining 25 percent. This means the plan will cover $1,500 and the subscriber will pay $500.

A person can stretch the $2,000 initial coverage by using lower cost drugs. Consult with your doctor about choosing a generic drug or lower cost drug that would work just as well for you.

Click Here to read the rest of the article.

PacifiCare Health Systems Inc., the seventh largest health plan operating in Santa Clara county, announced on Tuesday it is partnering with six major retailers to market its new Medicare Part D prescription drug plans.

The marketing agreements with Target Corp., Walgreen Co., Albertsons Inc., Safeway Inc., Longs Drug Stores Corp. and Medicine Shoppe International Inc., cover nearly 11,000 retail locations nationwide.

Under the deal, PacifiCare — which last week was acquired by UnitedHealth Group — will provide information about the prescription drug plans, including enrollment kits, free-standing kiosks and sales materials, at its partner stores.

“Our goal is to help make choosing and enrolling in a Part D plan easier for America’s seniors, and we are confident that our partners will play a key role in providing information and resources that will bring more clarity to Medicare consumers,” said Jacqueline Kosecoff, PacifiCare’s executive vice president of specialty companies.

According to Reuters, UnitedHealth has enrolled more than 2 million people in Medicare Part D Programs.

The enrollment is “very consistent with our expectations,” said UnitedHealth spokesman Mark Lindsay, especially given the company’s history of providing a drug discount card to seniors.

The figure appears to show UnitedHealth will reach its forecast for 2006 enrollment in the Medicare drug plans. UnitedHealth has forecast that by the end of next year, 2.4 million to 3.4 million beneficiaries will enroll in its Medicare drug programs, including Medicare Advantage plans.

Medicare, the federal health insurance program for 42 million elderly and disabled Americans, will begin offering prescription benefits January 1 through private companies. Enrollment in the plans began November 15.

UnitedHealth said the first month of enrollment shows “strong interest” in its plans.

“We are finding seniors understand that the value of Medicare’s new prescription drug benefit outweighs the complexity,” Lois Quam, chief executive of Ovations, the UnitedHealth business unit that serves older Americans, said in a statement.

The company said it has seen a sharp increase in online enrollment through the Web site for its plan endorsed by AARP, the large advocacy organization for seniors.

The enrollment includes individual, government-sponsored and employer-sponsored program participants in the stand-alone and Medicare Advantage prescription drug plans, the company said.