The Pharmacy Chick

Flying the coup in retail

Obamacare: Another Medicare D fiasco or not?

Filed under: Uncategorized — pharmacychick at 3:51 pm on Tuesday, October 1, 2013

If you were practicing pharmacy when Medicare D first came into being, you remember the life-altering nightmare it became for all pharmacies.  Cards were not received.  Plans were not updated.  Phone lines were jammed.  Claims didn’t adjudicate…for weeks.  Nothing I had ever experienced on Jan 1 of ANY year ever compared to the nightmare that the beginning of Medicare D was.  And for patients, not once inch of slack was ever given to pharmacies.  It seemed that to most of the seniors banging on my counter that Jan 1 was the onset of their Nirvana to cheap drugs, whereas in reality it was more like the Apocalypse.  Many recipients held off getting prescriptions in December under their existing plan just to load up on Med D. The only people to whom it didn’t matter were retirees that had plans that didn’t change: those lucky lifetime recipients of employee sponsored lifelong plans.

I really don’t know what this new Obamacare is going to mean for pharmacy.  I doubt any of it will be good.  Its a rare day when anything NEW that comes from the government actually benefits pharmacy.  Every new regulation come with new paperwork and requirements and I am sure this will also.  On a personal level, I can see that this will probably create a lot of new ” Plan terminated” rejects starting Jan 1.  What I dont know is if Obama ‘s cronies have their crap together enough to have all the adjudication requirements and card distribution in place so that Jan 1 people will actually be able to USE their benefits.

You can bet that if I get a rejected claim, that it wont’ be ME calling for assistance. I remember all too well Med-D.

Should be interesting….


Comment by pat

October 2, 2013 @ 10:45 am

insurance companies will be covering people who sign up. why would your beef not be with them? it is not a federal insurance program.

Comment by Pharmaciststeve

October 2, 2013 @ 4:08 pm

Another example of expectation of products/services expected to be paid.. falling dramatically short of products/services provided.

If insurance companies wanted to be truthful with people they insure.. they would not put healthcare providers in the middle of billing for services and the job of telling the pt .. that something isn’t paid for or paid maybe less than the pt expects..

A lot of problems would be solved if we went back to Cash on delivery of the Rx… and a receipt that the pt send to their insurance company.

After all the pt’s insurance is a CONTRACT between the pt and their insurance company

Comment by wellillbe

October 3, 2013 @ 9:43 am


The government runs the exchanges and will be responsible for getting the info to the insurance companies in the first place, That in and of itself will cause a huge delay..

Comment by PharmacyJim

October 6, 2013 @ 4:36 pm

True, PC. I remember the nightmare that was Part D when it began. Wonder how much medicine we all gave away to get patients by? I warned my colleagues the other day to expect a similar situation come January 2nd (we are closed the 1st). And before anyone thinks we are being partisan, Medicare D coverage began under George W. Bush. It is just that most government programs don’t work as smoothly in real life as the politicians portray.

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