Medicare Part D was rolled out today, 01/01/06.
And they dropped the ball.
All of the major claims processors (Humana, Paid, AARP, to name a few) had issues. On a whole, it looked as if their software engineers had missed deadlines, and failed to understand basic integration into pharmacy software.
What this means for Layman Pharmacycustomer is that what you were told by your new Medicare Part D provider is not true. At least not today, and probably not for a few more days.
I ran a prescription for oxycodone that returned a $335 co-pay. The lady, understandably surprised tells me it's supposed to be $5. She's right, it is. But I can't sell it to her, because I havn't been paid the remainder because the insurers software isn't working.
The insurer calls us up and tells us to override the co-pay. Who will keep track of that? The way things move where I work it will be buried in a pile of similar claims and we'll be lucky to see payment for any of them.
Let me politely rebutt the insurers for the sake of all pharmacies across the country: We will not pay for your mistakes. You missed the deadlines, you're software doesn't work, you can pay for it buddy.
And it's a shame that so many customers got shafted. Let's hope that most people weren't counting on everything to be working smoothly and were prepared.
Itchy_turd - 1/02/2006 01:23:00 PM
I wonder how much money the big insurers you mentioned wasted in the late 90's getting ready for Y2K, compared to how much they should have spent getting their systems ready for the new Medicare plan.
But I'm sure this was carefully planned out ahead of time. Obviously, the Republicans that pushed this through will be playing both sides of the fence. They'll take credit for supposedly intending on helping out the citizens with the health care program, and will talk about how implementing it was so disastrous that we would never want to have a larger national system of health care (obviously trying to sabotage a platform for the Dems in '08, particularly Hillary, and also helping the insurance lobby). Then they'll cut Medicare and Social Security more.
Our whole healthcare system is a damn inflated scam.
You should tell every pharmacy customer with insurance/co-pay issues to go home and call their insurer and bitch them out... repeatedly.
Chuck - 1/03/2006 12:39:00 AM
What I'm seeing today is that the networks utilized in Medicare Part D (MPD for short) are being overwhelmed with traffic and, like a web page that can't support it's bandwith, are timing out.
I then have to explain the nature of the internet to those on the recieving end of this punishment, typically the elderly.
I suspect you're right concerning the Republican stance. However, the way MPD works, is that it pits private insurers against each other in the market while making use of medicare moneys. Therefore, the insurance lobby will want to continue to get medicare money, so politicians (Republicans and Democrats alike) will continue to funnell government money into it.
Jamie - 1/04/2006 04:30:00 AM
"And they dropped the ball."
I'm so not surprised. In my limited experience, all insurances find and take every chance they can to screw people over, especially those who need help the most.
Itchy_turd - 1/04/2006 07:10:00 PM
Well, we're on day 4. Give us a status report.
"...the way MPD works, is that it pits private insurers against each other in the market while making use of medicare monkeys."
Do you think it has lowered prices for the consumer any?
Chuck - 1/04/2006 11:42:00 PM
One word. FUBAR
Day 4, the insurance providers have closed their telephone lines. In a situation where I cannot get a card to work, I call then for help. Now there's no one there. Most of the major ones, AARP, Humana either tell you "Due to high call volume, we cannot take you call right now." Or they just give a busy signal.
As a customer, your co-pays aren't what you were told they would be. So litterally millions of people are calling asking, "what the hell?"
Still, most people seem to be patient with me in the pharmacy. They realize that the problem lies not with us, and we're the ones who are picking up the slack for hundreds of inbred software engineers.
For a few customers I have been giving a three day supply of their medicine if their claims will not adjudicate (some restrictions apply).
Jamie - 1/05/2006 02:21:00 AM
For some reason, my first thought was 'unbelievable', but it's not, really. It's so typical it's just not even funny. I know I keep repeating myself, but I'm just beyond words at this point.
Itchy_turd - 1/05/2006 04:12:00 PM
Itchy_turd - 1/05/2006 04:13:00 PM
Jamie, your reaction of "not being surprised" and feeling the situation is "typical" is part of our country's biggest problem. But I'm not trying to pick on you specifically, we are all guilty of it to a degree...
We have been conditioned to be complacent to where shit like this, or issues of obvious corruption between lobbyists/private interest groups (Abramoff) and gov't officials (Delay), takes place and the American people are more concerned with Ashley fucking Simpson. And it the voluntary dependancy on the damn multi-national corporations that are controling us that keeps us from rocking the boat.
I swear, this country is going to have to have some shit like the 60's x10 happen and some people start gettin' "taken out" (figuratively or literally), before this place gets any better.
"Everyone I know with a gun is thinking 'I may have to use this.' "
- 1/05/2006 06:43:00 PM
Oh grief. What is it I'm supposed to be guilty of? 'Cause I can't decipher 99% of that stuff you wrote. I may be complacent, but I do what I can where I can, and I'm smart enough to know that people "gettin' "taken out"" is akin to flying a 747 into a skyscraper--as likely to get my point across as pigs are to fly.
Chuck - 1/05/2006 10:03:00 PM
Jamie, your reaction of "not being surprised" and feeling the situation is "typical" is part of our country's biggest problem. But I'm not trying to pick on you specifically, we are all guilty of it to a degree...
Are you saying that apathy is the problem, or that desensitization is the problem? Or is it the same thing?
Itchy_turd - 1/06/2006 11:29:00 AM
Let me ellaborate.
Historically, our generation is likely (at least as I see it) to be labeled as "complacent consumers", just as the Greatest Generation (Depression and WWII era) would fall under "tradionialists", and the Baby Boomers as "non-conformists".
In my previous post, I was referring to the "complacent consumer" trait in a negative light. The reason was that we were talking about the ineptitude of the insurance companies to not only be unprepared for the new Medicare plan, but then *refuse to communicate to the consumer or the companies dispensing the drugs!
Unforetunately, I doubt there will be anything done about the situation. We will allow the insurance companies to regulate themselves and fix their issues at their own pace, and once it's finished let them cop out and give them a free pass like it never happened (we'll be happy to get back to the status quo). The Medicare situation is not even reported on any of the major news sites.
"Guilty" may not have been the most appropriate word, but history may judge our generation as being guilty of complacency in matters we should have been more active on if things continue along some of the paths we are taking.
On the otherhand, traits such as "tradional", "non-conformist", and "caplacent" could be consider both negative and positive. A possitive effect from the "complacency" is for instance our generation seems unusually "PC" or willing to accept other cultures, lifestyles, veiwpoints, etc.
But accepting issues like faults within the gov't or insurance companies may be a step (or two) past the line of where "complacency" goes from a positive attribute to a fault.
LOL, I didn't mean to state it like a Pat-Robertson-rant, if that's how it came across.
- 1/07/2006 04:12:00 AM
Forgive me for being a little offended; I felt like I was being attacked because I know and stated that such things are unlikely to be changed. I feel a lot of the responsibility for the state of things lies with the media (I'm currently on a soapbox with them, not just for reasons like this). They give us what news they want us to hear and nothing else. You mentioned Ashley Simpson--who has given that article more weight and importance than the Medicare mess? I did see a short piece on one of the local stations a couple of days ago, but it was stuck deep in the show and given about as much time as they would an oddity or trivial piece of news. I have friends online who are Canadian and Australian, and they seem to know more about the war in Iraq than I've ever seen reported on any news program here. My Canadian friend told me that on their news, they get mortality statistics and the like, which is another thing I rarely see much of on the news here. It's like the government has decided, well, hey, let's just give these shmucks what we want them to know about the non-reasons we have for killing innocent people (ours and theirs) in Iraq. If we don't tell 'em, they'll never know it's bullshit. And remember back when the whole Monica Lewinsky debacle was big news? Because the news people thought this was a big story (that 'sex sells' thing proving to be true?), a president who had reduced the budget deficit, given most people a way to have health insurance, caused unemployment rates to be the lowest they've been in ages, and given us cause for the biggest economic boom since post-WWII, was impeached. And now, Bush, who has spied on the people he's sworn to protect, lied to us about reasons for invading Iraq (what the fuck did Iraq have to do with 9/11?), and reversed all the positive things the previous administration had done, is still sitting up there in the oval office smiling like the shmuck he is, being fed words through an earpiece he doesn't even have the sense to parrot correctly. It's insane that we put up with shit like this, I agree. But until it's really brought to the forefront of the media like the important items they are, the American people are unlikely to think it's important enough to warrant action. I guess what I'm basically saying is, the majority of us act on what we're fed, and I've taken inordinately long to get around to it. I think you're absolutely right, it needs to change. But until it's pointed out to us, nothing will ever be done about it.
(Wow, sorry to get so long-winded.)
Chuck - 1/07/2006 01:29:00 PM
The first rule of Fight Club is that you don't talk about Fight Club...
- 1/07/2006 04:08:00 PM
I prefer the Third Rule of Fight Club, personally.
Tyler22 - 2/01/2006 03:31:00 PM
I hate this damn medicare thing! I wish these assholes had to work in our shoes for a day!
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