Many are finding Part D is a challenge

A question that is common among those on Medicare is, "Which prescription plan have you selected?

A cartoon in the Kansas City Star Sunday illustrated the thoughts of many Medicare beneficiaries. It showed a maze with the words Medicare System on the first wall. In the midst of the maze, someone is calling out, "Hello? Anybody?"

That is the way many are feeling at this time. There are many who have questions and are not getting answers.

Only about half of those eligible have signed up for Medicare Part D. The new plan began this month and is the biggest change in Medicare since Medicare started. It is big and also has created difficulty.

The prescription card for those signing up by Dec. 31 became effective this month. Many have received their cards and are using them. They are finding how they are going to work and if they need to make adjustments in their prescriptions. Certainly the doctors and pharmacists have to make special effort in working with the new programs.

This is a new program to the government and to all of the companies. With any new program there are glitches and snafus. This is not limited to one company, but is industry wide.

Many of the Medicare prescription Web sites that are to be used by pharmacies were overloaded. There are also issues in knowing how to use the Web sites. There are other things that are being done by the companies, such as setting up new departments to work with pharmacies and enrollees. This can be helpful for those needing their prescriptions filled, but have not received their card.

If the card has not been received and they need their prescription filled with some of the companies the enrollees can pay for their prescriptions -- if affordable. They can send the information and receipt to the company for reimbursement. Every company may work differently, so verify it with your company. If the prescription does not need to be filled immediately, you may want to contact your company to get verification.

Remember, this is the biggest change to Medicare since the program was started. If you are caught up in trying to get your prescription and you are having difficult -- take a deep breath. This program has been implemented by the government on a "fast track." Still, they have had more than two years to get ready for it.

It has been only a little more than three months since the government notified companies that their program had been approved for sale. The frustration is understood by the companies and the government and everyone is working to resolve the problems as soon as possible. Folks, that is the situation and it will work out. It will be interesting to see how it does work out.

Since this has been implemented at a fast pace, there have been many people working hard and extra hours to get it to the point it is at present.

At the present time the formulas that an enrollee needs may be different than what is provided by the company. Bill Young, Insurance Specialties at Purdy, Mo., says that according to an interview with a Pharmaceutical representative last week on National Public Radio, the government has issued a directive stating that any person enrolling in part D program will have the opportunity to have a one month supply of non-formulary drug filled under their Part D plan. This will give the enrollee time to work with their doctor and pharmacy to evaluate alternative formulary drug program.

Bill said, "If the doctor does not believe that an alternative drug is appropriate for the patient, then the doctor must communicate with the Part D provider company to request an exception. The doctor can communicate with the company either by phone or written communiqué."

Some of the participants in the plan will save as much as 50 percent on their annual cost of prescriptions. The new program will be beneficial for them. There are those who have qualified for a reduced premium or not any premium at all and hardly any co-pays. This will also beneficial to them.

Many have not signed up, because they remain confused and have not made a decision. Some have not taken the time to enroll. Others are waiting to see how things go. Still, there remains Medicare beneficiaries, who have low expenses for Medications and do not plan to enroll during this open enrollment period.

A large number have a prescription plan that equals or is better than Plan D. It will be interesting to learn how many fall in this category. These individuals will not be penalized if they sign up later. Those not having another plan will be paying a 1-percent penalty for each month. Many will find it is better to go ahead and enroll to avoid this penalty at a later date. It is an insurance against higher premiums later.

Plan D remains a challenge for many.