Medicare Part D Is a Mess

Having trouble with Medicare Part D? You aren't the only one.

Many of Medicare's poorest and most sickly patients are going without their medications because of administrative glitches, misinformation and confusion surrounding the new Medicare prescription drug benefit.
Experts had warned that many of the 6.4 million low-income people who get benefits from Medicare and Medicaid could miss out on their life-sustaining medicines when their drug coverage shifted on Jan. 1 from Medicaid to private plans sponsored by Medicare. In interviews, advocates for the elderly as well as lawmakers and seniors themselves indicated that that's happening. Some, such as Deborah King of New York, were placed automatically in new drug plans that don't cover their medications. Others were getting stuck with extra out-of-pocket fees because their new enrollment status couldn't be verified.

Medicare's contingency plan for patients who aren't enrolled in drug plans also is proving problematic. The agency wants pharmacists to give these customers short-term refills at no cost and bill Medicare later. But some pharmacists don't know about the agreement, and others are balking because they fear they won't be reimbursed.

"There's almost nothing that isn't going wrong," said Jeanne Finberg, an attorney for the National Senior Citizens Law Center in Oakland, Calif. "People are crying. They're calling their legislator's office in tears."

These problems and jammed phone lines that prevent pharmacists from confirming customers' plan enrollments mean that many patients can't get their medicine. While the extent of the problem is unclear, health experts say the situation is dangerous because those patients who get Medicare and Medicaid benefits have higher rates of chronic illness, disability, cognitive impairments and other health needs. Their lives and livelihoods depend on their medicine.

There is help available. NAMI-Minnesota has set up information sessions around the state. Get more Minnesota information here and here. NAMI should have resources here as well.

Contact your mental health provider for more individual help and to access medication assistance programs.