Posts tagged 'prescriptions'
This is a story about a man named Don. It really happened, and it really happened to Don.
Don really enjoys playing his guitar.
Tuning it, he says, is so much easier than getting into tune with his Medicare prescription provider, called Medco, (one of the largest Medicare medication distributors), which kept telling pharmacies Don's benefits had ended.
He recalls his first trip to the pharmacy this year.
"I gave them my card, they looked it up and they said that's been terminated."
Since Don needs seven different prescriptions every month for his heart, blood pressure, and diabeties, he started getting concerned, as those bottles were nearly empty. Many of us can relate to that situation. I get nervous when the number of pills I have left gets low , especially if my doctor is out of town, I don't have a new prescription or my check hasn't arrived. I take 6 different pills every day for heart, blood pressure and a few other issues.
Back to Don. He kept calling Medco. Over and over until it was ridiculous.
"I probably made 35 calls to them."
Medco kept telling Don he wasn't covered, while Medicare kept telling him he was.
"I was getting really frustrated about it."
Then he thought the frustration would finally end, when he got this letter from Medco, which said he was covered.
But despite that letter, the pharmacist said his records showed Don still wasn't.
"I call Medco and I fight with them on the phone about it, they keep telling me I'm terminated."
Now, Don really started getting worried. When you are in a situation like this it seems like you get stuck in the middle and everybody is going back and forth with no end in sight.
He says he certainly can't afford the $700 it would take every month to buy his meds without Medicare's help.
"I just figured I'm going to have to quit taking them and take my chances, whatever."
Most local news channels in every city and state have some sort of consumer problem solvers segment where the news channel will help you with your problem. Don definitely had a problem and it could have turned out to be fatal for him. With his pills running out, Don finally called the 2News problem solvers, and they contacted both Medicare and Medco.
Later that very same day, Medco called Don, to clear up his situation.
"They just wanted me to know that they had updated everything in my file and the card is now working and I could go pick up my prescriptions anytime I wanted to."
Finally, Don finds himself in perfect harmony, with his music, and his meds. If you find yourself in a similar situation, don't give up. Keep trying to deal directly with your drug company, medicare and your pharmacy. If that doesn't work, do what Don did and get extra help. There is usually a way to work it all out.
We have been hearing a lot about computerized electronic prescriptions lately. The old joke about doctors’ handwriting seems to be true in many cases, and unfortunately, in too many situations, pharmacists can’t decipher the scribble and end up dispensing the wrong medication to patients. This is never a good thing, and though in many cases, the patient catches the mistake or the medication is not harmful to the patient, in a lot of cases the medication is not only harmful but fatal.
The Centers for Medicare and Medicaid Services (CMS) have been trying to get doctors to switch to electronic prescriptions to eliminate the high number of problems with prescription errors due to handwriting, but so far many doctors have been resistant. CMS has offered some bonuses if the doctors will at least give it a try, but there hasn’t been much acceptance of the idea.
Some doctors worry that all the software available to the pharmacies and the physicians will not be compatible, leading to other problems in addition to the handwriting issue. CMS says that Medicare expenses are increasing (as we all know), and that these mistakes due to handwriting issues are increasing expenses even more – especially when the wrong prescription has to be thrown away and a new one has to be filled.
CMS has gotten very serious about making the change to electronic prescriptions. They are offering cash back to the doctors who make the change and are error free. In order to get doctors to switch, which CMS says will make the system better, safer, more effective and efficient and more cost effective, doctors who go electronic will receive a 2% increase in their Medicare payments in 2009 and 2010 and a 1% increase in 2011 and 2012.
Only about 2% of all prescriptions are filled electronically every year. Because this number is so small and most of the rest of the prescriptions are handwritten, over 1.5 million patients – over 530,000 Medicare recipients – are harmed every year due to prescription mistakes. The Pharmacy Board has investigated thousands of prescriptions at random and found that there were high percentages of errors involving the type of medication prescribed, the dosage and wrong or incomplete directions.
At present, the Pharmacy Board is working on 48 different prescription programs. They are working with pharmacies and physicians to work out compatibility issues. In the meantime, if you can get your doctor to at least give you your prescriptions typed into his computer and printed out; there will be less room for error. CMS hopes to begin the electronic program by the end of this year.
The news tells us on a regular basis about prescriptions gone wrong. A physician prescribes blood pressure medication for an elderly patient but the pharmacist can’t read the handwriting, so the patient ends up with a blood thinner which causes a hemmorage that lands them in the hospital. Or, a child is prescribed an antibiotic but ends up with a cancer med, causing long term health issues.
Medicare has established a way to reduce or eliminate this from happening: E-Prescribing. By prescribing on line and eliminating handwriting issues, it is estimated that the majority of misread prescriptions can be eliminated. In addition, this would reportedly save pharmacists about 150 million follow-up phone calls to doctors’ offices per year attempting to clarify prescription medication names, dosages and amounts.
Starting in 2009, Medicare will begin giving doctors who E-Prescribe a 2% bonus on top of their fee for E-Prescribing. Starting in 2011, the bonus will go down to 1%, and in 2013, it will go down to 0.5% for one year. The five years of gradually declining bonuses are an incentive to help doctors’ offices begin prescribing in this manner and get them in the habit of doing so, making prescribing and filling prescriptions safer and more efficient for doctors, pharmacies, and, most of all, the patients.
“There are terrific human and financial costs to illegible prescriptions,” Mike Leavitt, Secretary of the U.S. Department of Health and Human Services, said on Monday. “There are a lot of people hurt and a lot of time spent trying to sort out bad handwriting,” he added.
E-Prescriptions have been on the radar since about 2006, when pharmacies that participated in Medicare were mandated to be able to take the E-Prescriptions. Implementing this method of prescribing medication should create a profound reduction in prescription mistakes.
There are estimates that at least 40% of individuals that have Medicare Part D do not understand their coverage.
Part D is designed to cover many of the drug/medication costs of individuals enrolled in the plan. Since Part D is not part of the original basic Medicare coverage, there is usually a premium charged. An individual can purchase a Medicare prescription drug plan or a Medicare Advantage Plan.
Both types of plan have limits to them, so it is essential that you research the plans that are available and find what is right for you. With most plans, you will pay a premium and they will pay part or all of your prescriptions. There is extra help for individuals on very limited income.
It is important to note that depending on the plan you choose you could be liable for up to $2,500 in prescription costs. It is important to consider the cost, the amount of co-pays and the amount of coverage you will have. Additionally, there are supplemental plans – often at little or no cost – from organizations such as AARP, Humana and many other companies. These plans cover some costs that Medicare Part D does not. Sometimes these plans offer a discount on prescriptions.
To research Medicare Part D, drug costs, which prescription plan is right for you, and other information, visit the official Medicare website at www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) and ask a representative for the information you need. You can also check for supplemental plans by checking the internet and type “Supplemental Prescription Medicare Coverage” into Google or any other search engine, and you will find several pages of plans.
Whatever you decide and whatever questions you have, take the time to do a little research so you can find the coverage you need – and so that you can understand the coverage you have.
