The Medicare prescription drug program depends on beneficiaries choosing the plan that best suits them. But how can they be expected to choose the right plan when they can’t get straight answers about the plans? Government Accountability Office investigators found that the plans only give correct and complete information about a third of the time. Here are some more details from the report, as reported by The New York Times:
Investigators placed 900 calls to 10 of the largest companies that offer drug coverage to Medicare beneficiaries. They reached customer service representatives in 864 calls.
The plans provided accurate, complete responses to one-third of the calls, 294 of the 864. Twenty-two percent of the 864 responses were inaccurate, 29 percent were incomplete, and no answers were provided to the other questions.
Two of the 10 companies gave inaccurate or incomplete information at least 75 percent of the time, the report said. And operators at the same company sometimes gave different answers to the same question.
Posted by Phillip Brownlee
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48 Comments
And if you called state Medicaide officials or Federal Medicare officials, or officials with the IRS, with a set of questions, how many of those calls would be answered correctly or consistently?The best thing anyone can do who wants answers to the Medicare Prescription Drug “Part D” program is to find a competent agent who can answer their questions.As an agent who has sold over 100 of these things, I can tell you that “home office” advice on ANY financial product will fall short of what a good agent will be able to advise, this is very true of Part D plans.I can also tell you that many of the problems begin on the government side of the “partnership.”The problems would therefore be much worse if Uncle Sam was running the entire program.I would also add that the New York Times is on a Jihad against the Bush administration, and I trust little of what the Times has to say.I am betting that the Times study and story itself contains a few errors, most of their work does anymore.
You are a clown and a shill for the failed bush administration Paul.
Hey Paul? Why did you run away from the Ann Coulter thread?
Why do you run away from any thread where serious questions are put to you?
You are invited to post in your defense. But I say your quitting hard fought threads makes you a shill and a coward.
Paul,”The plans provided accurate, complete responses to one-third of the calls, 294 of the 864.”
These are the companies the people have to deal with. You, on the other hand, claim different. We have only your word, which, in my book, is more suspect than the times., You have proven yourself to be, as JR stated a shill for the Bush administration.
I’m sure Rush Coulter will echo your remarks, as they, too, are blinded by falsehoods and outright lies.
The whole prescription fiasco was brought about by an administration so out of touch with the common man, that it couldn’t find a decent medical plan if it were stuffed where the sun don’t shine. Hopefully, we can get some decent leadership in 2008 that will straighten out the mess and give health coverage to the people who truly need it.
JR, I’ve come to admire you for your uncanny ability to disagree with someone and thoughtfully criticize their arguments without stooping to namecalling.
The whole thing is a mess. As a home health nurse, I can tell you even if the subscribers get accurate info, which often they don’t, it’s too hard for them to understand how it works. I can’t for the life of me understand why they made it so complicated, so that even those who are providing the services don’t understand it half the time. The pharmacies are really struggling along with all those who need prescription drugs in order to live. Thank God, my patients have advocates that can assist them through the complicated process, but many seniors don’t have that advantage and they fall throught the cracks. It’s a disgrace the way this was set up, it didn’t have to be like this.
I never thought a liberal like Phillip Brownlee would use a phrase like ‘Eenie, meenie, minie, moe’ with its racist history. What’s the next line of the rhyme Phillip?
“Catch a n*gg*r by its toe.” The KC Star just blasted a brewery for using the phrase on a billboard ad. The ad was changed.
Where’s the racial sensitivity?
Mary Caruso et al: I agree with you. Medicare’s “Part D, Prescription Drug Program” looked good on paper. It was supposed to help senior citizens cope with fast rising costs of prescription drugs at a time in their lives when their incomes are dropping.
But, in practice, “it just don’t work that a way.”
As a senior citizen myself, albeit a healthy one, thank God — back in May as some kind of deadline approached, I was bombarded with telemarketing calls very similar to the old auto club and credit card telemarketing calls. These calls offered or more accurately, threatened me with invitations to join the “Part D, Prescription Drug” programs being offered by probably 20 or more health insurance companies in a bewildering maze of monthly fees and claimed benefits.
One telemarketer with whom I must have visited with more than 30 seconds offered to send me a package of information but actually signed me up in the program. A few days later I started receiving bills and paperwork but no explanation of benefits.
I then wasted the next month extricating myself from the program including consulting an attorney about my options. I was never able to talk with anyone with that company on the telephone with any knowledge or authority to cancel the unauthorized sign-up. In fact most people I talked to would not reveal their name nor company affiliation nor which state they were located — on grounds of THEIR privacy concerns!
I also wrote three scorching letters, special delivery, return receipt requested, to an address in Louisville, Kentucky. Only received form letters in response, never any letters referencing my letters or concerns.
To this date, I have never received an explanation of benefits nor a direct cancellation of the bogus sign-up.
Almost everyone I have talked with about this Part D, prescription drug program, including the pharmacists who work with it daily, agree it is a poorly planned, poorly executed program –basically a multi-billion dollar rip-off of the senior citizens of America and their care-givers. It even rips off the U.S. government and state governments in thousands of nursing homes — so its actually a case of the federal government defrauding itself!
As far as I can determine, our U.S. Senators and Congressmen are asleep at the wheel on this one, letting America’s senior citizens get roasted big-time by this faulty program.
“sigh” It’s government. Seniors getting a break on drugs off the younger generation, but it’s riddled with problems and peopling having to pay?
Rmember that the senior population is the richest demographic group in the USA. I wonder if free drugs is just a break for the rich?
What has amazed me is the way the drug industry bought the entire congress for their drug bill. This does not mimic the Veterans Affairs program which works by bargaining lower prices by volume buying. This would have saved billions and the drug industry stopped it dead by buying our congress. Soon or later, this will arise!
Joe: Sorry, its my understanding that the federal government doesn’t contribute to the costs of the prescription drugs. The federal government organized the program through Medicare.
The program is set up like a pyramid scheme, seniors who don’t use prescription drugs but pay the monthly fees actually pay for the costs by the big users of prescription drugs. The program kills the incentive of those using prescription drugs to shop around and even eliminates that competition by telling the patients which pharmacies they can use. Essentially, it makes the large pharmaceutical drug companies richer than ever.
Whether or not senior citizens are “rich” is just a luck of the draw — did their retirement programs remain in effect, did their stock investments work out, did their life-long businesses finally sell for a profit?
And what about the younger people approaching retirement — are they prepared?
GSTER: RIGHT ON!
I just slogged through that forest last month. Once I settled down, quit the, Oh poor me pity party, I realized that it wasn’t all that difficult. Yeah, there are a lot of plans out there. Yeah, you have to read them carefully and compare. But the basic Medicare and You book is written in easy to understand language. And after a while, you realize you’re reading the same thing over and over and that most of it doesn’t pertain to you. Ok, a lot of people lack education, but anybody who can read can find their way through the thicket.Plan A, you get regardless; Plan B costs you $88.50 a month and comes out of your SS check. The only options left are which Plan D to buy, but if you don’t take any drugs, don’t buy anything. If you do, well, investigate, study and don’t panic. It makes sense, it really does.It could, I admit, be even easier, but things change once the obstacles are discovered.
Dennis: I think you are confusing Medicare’s health plans, Parts A and B. And to that, you should add a “supplemental” health plan from a private insurance company to pay for the things that Parts A and B don’t pay for.
But, ordinarily, your Medicare Health Plan plus your “supplemental” plan from a private insurance company DO NOT pay for any prescription drugs.
There might be exceptions to the above for retired government employees, etc.
But here we are talking about the “new” (within last several months) Medicare Part D, Prescription Drug program. These plans are offered by various private companies such as Humana, AARP’s contract company, etc. The monthly charge is usually $20 to $50/month for plans with deductibles, co-pays, no pays (the infamous doughnut hole), etc. This plan tends to eliminate competitive shopping for prescriptions.
Its my understanding the non-users of the plan pay for the heavy users of the plan. In order to be advantageous to the customer, the customer must use some fairly high amount of prescriptions per month … say $100/month or more, I don’t know the figure.
JRWhat is your real name? You just called me a shill and a coward.At least I don’t hide behind a fake name.I will do as I please. I will write when I want to, I will quit when I want to. I am not at your beck and call you control freak.I don’t intent to stay on any thread here for more than a few days, they all tend to disintegrate after awhile.You tend to turn each thread into a personal attack and get off topic.It only takes me a couple of posts to mitigate or rebut the liberal spin of any story, then I am done.I dont need to defend myself.I enjoy it that people like you are angry with me, but I dont feel compelled to read all of your tripe, much less respond to it.I move on.You, on the other hand, continue to bully and insult me and other conservatives, alienating and repulsing those many people who look at these posts yet never post anything themselves.JR is the HEART of the democrat party, a once proud party now dominated by thugs who try to shut up everyone who disagrees with them.
ShockedI agree with you. Mitt Romney in Mass. in in trouble for using the name “tar baby” in total innocence. He has apologized, not realizing that some consicer the B’rer Rabbit reference to be racist.I bet the NAACP gives the Eagle a pass on the ennie menie stuff, dont you?
Well Paul F Rosell.Congradulations.You have become the very same bitchy, whiney, name calling, devisive, verbally abusive type of person you claim to loathe.I’m sure you’ve got spin down to a fine art.
Now state the facts and take your own advice and move on since you’re above all this.
Are you movin’ on yet?
gsterYou are wrong in saying that there is no “bargaining” going on for the drugs.The premiums for almost all of the drug programs are ridiculously low, if based on full retail cost.Each insurance company provider gets “rebates” directly from the drug company.Those rebates are based on quantity discounts, the willingness of the manufacturer to work with the insurance company on 90 day mail order discounts, and the copays the consumer pays based on the out of pocket costs the consumer pays for the drug.This rebate mechanism, by law, must be explained in the disclosure of every drug program. The rebates are intended to keep the premiums low.
Paul – From what I know , it does not even come close to the Veteran Affairs program used by the VA. If it does, I would like to see that; I’m a retired veteran and it makes me mad to see what is being done!
JWinkYou are wrong.All of the drug programs provide a very strong incentive for seniors to switch to generics.Also, while the “dougnut hole” can be very rough on people, the whole point was to make seniors aware of the full retail cost of the drugs they were using, and transition those who could use generics into generics. Also, the $2250 threshold for entering the “donut hole” is based on full retail price, on ALL Part D programs.So the critics claim there is no incentive to shop around for drugs, but then also criticize the donut hole.You just cant have it both ways, because the donut hole is a huge part of the incentive to shop around.Folks, we are talking about going from NO Medicare drug benefits at all to a plan that is saving many people thousands of dollars a year.Of course those who dont have claims pay for those who DO have claims.DUH!When your hero Kathleen Sebelius was Insurance Commmissioner, it was her job to make sure that insurance companies had enough healthy people to subsidize the claims for unhealthy people. Assuring the financial health of insurance companies doing business in KS is the primary job of the Insurance Commissioner.That requires that some people HAVE to pay more premiums than the benefits they receive.
MaryPlease go back and read some of the news articles when Medicare first went into effect in 1965 and 1966.Every new program will take some time to get the bugs out of it.I admit, up front, that I am not making a profit on my Part D business, and that it can be VERY complicated and frustrating.The same can be said of TRADITIONAL MEDICARE PART A and PART B however.For instance, there are roughly 13 different tread mill or stress tests, from what I can count.Most Medicare billing errors come from this complication.Health providers often enter the wrong “proceedure code” and us agents have fix the “mess” afterwards.Capitalism requires consumerism, The American Way is to provide choices. You critics want the government to run the show, which will give us old fashioned Soviet Style medicine.
gstir,Why should Part D look like the Veterans program?Those who qualify for VA drug benefits EARNED those benefits.The VA is the BUYER of those benefits, the VA should negotiate those costs.The VA program is considered “creditable coverage” meaning there is no 1% penalty for anyone leaving the VA program to go to Part D.I have advised my clients, usually, to go with VA for their prescriptions.Most vets who stay with traditional Medicare also want a Medicare Supplement plan, however, which contains no drug benefits but pays most or all of the deductables and CoPays that Medicare doesnt pay.
Paul- I’m not talking about the philosophy , but the machanics involved. Why can’t that mechanism be replicated for this drug program?
The VA program is a “single payer” program.The customer, in the VA program, IS the VA.Competition is the best way to keep prices down, and turning the “mechanics” of the Part D program from a competition driven program to a “single payer” program will drive costs through the roof.I can tell you, I think most of the good health insurance agents feel like “slave labor” in this process.We have been drafted, but I believe it is for a good cause. I do this work partly from a desire to see the plan work, and partly from a “loss leader” marketing standpoint. I know that I will loose money on at least half of the D plans I set up, but every now and then I find someone who needs other products.In other words, the government, through the privatization process, is getting alot of “free” help in providing this service. Free help from people like me.I think that Part D will stand the test of time, pretty much the same as it looks now, even 10 years from now.I think Prescription Drug coverage was inevitable, and this is the best way to do it.It used to be that the poorest patients would go see the docter far more times than necessary, since doctors had “free” samples that they could give out to those who made office visits.Of course, traditional Medicare would be billed for the office visit, and the customer would walk out with a bag of pills.This method is more honest and straight forward, billing a drug plan for drugs, and subsidizing the premiums for the needy.Low income folks pay no premium at all, and the government, not the Doctor, verifies income eligibility.
Paul – RE: “The VA program is a “single payer” program.The customer, in the VA program, IS the VA.Competition is the best way to keep prices down, and turning the “mechanics” of the Part D program from a competition driven program to a “single payer” program will drive costs through the roof.”I don’t get it; it seems to me that you are saying the program works for the VA as a single payer, but wouldn’t work for some other single payer. There must be a better way as this system will implode at some time down the road.
gster,The Veterans pay virtually NOTHING for their prescriptions. Uncle Sam pays almost the entire cost. The VA program is essentially a retirement benefit, or deferred compensation for Vets.Veterans earned their program and are entitled to it.The Government will never be able to afford to treat everyone like we do our Vets.The rest of us SHOULD have to pay something for our plan. (When the time comes, I am only 47 lol).The costs of the VA program are going up dramatically, as the Baby Boomers age goes up.
OK- Thanks for the info.
gsterYou are welcome.
Eenie, meenie, miney, moe,Catch a MONKEY by his toe.
That’s the way I taught my kids. Anybody have a problem with that?
“and if he hollars make him pay $50 dollars every day”Golly, how do you make a monkey hollar and how do you make a monkey pay?Look RD, I do think society gets too politically correct and too touchy.However, Mitt Romney got in trouble for “tar baby” comment, when the term is often used to describe a sticky or difficult situation.It is only fair that the Eagle be reminded of the racist roots of the rhyme used in this thread.
RD, how do you make a monkey hollar?
compare him to paul and watch the “howling” begin.
Monkeys have feelings too ya know.
And he’ll gladly pay $50 to get away!
I was taught “catch a tiger by it’s toe” I heard the ‘n’ version for the first time about 3 months ago and was shocked.I guess you make a tiger holler by catching it’s toe;)
hey farm girl, want to make a “deal with the devil” ?? we could do some monkey shake downs and split the loot afterwards.Anything for a buck, you know us Republicans.
I did not even know the origin of eeny meeny minie moe. Not until Paul brought it to me.
I am younger than most here. It may be that time and social progress will obscure the painful roots of common sayings.
For instane? Most do not know that Ring around the rosy is ACTUALLY a rather morbid singsong “ode” to the Beubonic Plague!!
kfg !!! I agree with your take Paul v monkees! He is now advocating some sort of armed robbery of them.
Paul, you better recheck your info on the Vets program. If a vet is out of work, or his income is below a certain level, then he can use the services. I know that for a fact. Been there done that. If you are a regular wage earner, you are not entitled to use the services of veterans hospitels.
If you were discharged because of service related disabilities, THEN you can use the services for those disabilities. It is NOT a free pass for every discharged GI, and never has been.
How do I know this? Because when I was first married, out of work, and having a physical problem, the veterans service wanted income history, work history, and any and all other government services I might be using. After determining I met the criteria, I saw a doctor and was treated. If you don’t meet the criteria, you will not be treated.
Retired GIs do get full use of VA, and they should. They have done their service to this country and deservr that and much more.
Facts, Paul: they make all the difference.
There are several different tiers to Veterans Benefits. Retired Military have benefits that others don’t have. Combat vets qualify as well for different benfits.Veterans who can show a service connected disability can qualify for other benefits, even if not combat related.There is an entire group of benefits that is ONLY available based on means testing of the veteran, ie: income. Yes, the VA has its own “welfare” programs.I know this stuff folks, it is my livelyhood. The extent of my research on any client goes only so far as to urge that they inquire before buying anything with me. I dont want to sell them something they dont need.I have lots of vets who make VERY GOOD money and still qualify for benefits of some kind. It is not hard to do if you meet the right rules.Even so, I have a hard time understanding the rules and always have clients check with the VA office to figure out what someone can get. I dont have access to their service records, and only the VA can grant benefits.They wont answer over the phone because it takes research on the vet to find out length of service, combat zone involvement, service related disability, etc.Sometimes, the VA will perform the exam to determine cause of injury, I know this from PERSONAL experience. Also, the Vet must agree to income verification on the means tested programs.
Paul Rosell: You are wrong. And if you were telemarketing senior citizens to sign them up for the Part D, prescription drug program, you should be ashamed and certainly not admit it in public.
Now I understand a little more of the situation I found myself in when someone like you who represented themselves as a sales representative from “Phoenix” called about the Part D, prescription drug program.
Now I understand that virtually everything I was told was an outright lie designed to sign up people for the program over the phone without a signature and without giving a call back telephone number. The sales person who called me wouldn’t identify himself for “privacy reasons” but assured me he only wanted to send me information, not actually sign me up.
It then cost me many calls, many letters, a consultation with an attorney, to cancel the program.
Its a faulty program, hard to understand, only beneficial for senior citizens who use large amounts of prescriptions.
I recently spoke to an assembly of top Kansas health care professionals at WSU’s Hughes Center about this program that on the face of it has a seemingly good purpose but bottomline is basically a fraud on Kansas senior citizens.
JwinkYou are an ass.I know my stuff.I am an expert on Medicare Supplement Plans and on Part D.I am in full compliance with the law.
JM,I was asked why the Part D plan did not copy the VA plan as far as drug benefits were concerned. Please check up link.As you say, check the facts.You are way out of line here.Every week, I see people making in excess of 50K a year that have a medicine cabinet full of drugs with VA labels on them.You dont know what you are talking about.
JM, I think I posted a few above at the same time you did, not sure we are that far apart on this.
And JWink, sorry that I took personal offense at your accusations.You were wrong to accuse me of wrongdoing, I spend thousands of dollars a year in direct mail advertising to attract new clients.On top of that, I have hundreds of existing clients who I can legally call anytime I want to.I took offense at your accusations and responded in kind.I should not have done that.I am the first to admit that there are some bad actors in this program, as there are in all programs.I am sorry for the trouble you have had, but I have done a huge amount of good for very little compensation.I am proud of my accomplishments and you should be more careful — I am someone who could help you fix a problem if you would simply get over your prejudice and ask.I hope your problems are resolved soon.
Please ponder this:Did you get your money’s worth out of your homeowners policy last year? Or your auto insurance?I hope not, for your sake.People treat prescription plans different than any other type of insurance. They want it to pay off immediately, which makes it more like “prepaid” or a transation oriented product rather than traditional insurance.Having said that, I bet all of you have seen the TV advertisements for HUMIRA, a drug for RA or rheumatoid arthritus. That stuff runs around $1200 a MONTH. It is refrigerated, or at least she keeps it refrigerated, with a short shelf life, it comes in vials through the mail.One client of mine is now spending less than $2500 a year for a drug bill that used to be in excess of $15 Grand. (She takes other stuff too.)Also shop around for a drug called Somavert. This is another “specialty drug” with a short shelf life. A monthly supply of this drug, without insurance, can cost upwards of $4,200 a month. This drug is an “anti growth hormone” drug for people who develop a condition where the pituatary gland produces too much growth hormone. The condition is called “acromegaly” I think, from my notes and from the Pfizer web page. (Many of my clients dont know what they have, they give me the drug bucket or shoe box and I have to figure it out. I am NOT a telemarketer, I go to the home.)Anyway, I reduced this clients prescription bill considerably. After the first month, she will only pay 5% or $210.00 for a $4,200 drug.Before you get mad at Pfizer, the manufacturer, please understand that this is again a rare drug, for a rare condition, a drug with a SHORT shelf life that is very expensive to make.Anyway, I have seen real benefits for real people using Part D!I do have concern for those of you who find it confusing or have gotten bad service.I get frustrated daily with the red tape. I understand those complaints!However, those of you who complain that it is too expensive for those who arent taking any drugs?Cry me a river!I know at least two people who would LOVE to trade places with you!
I’m not informed as to this and must leave Paul to J M and Jwink.
Paul,If those individuals making over 50k, as you say, were retired military, or government, then they are entitled to VA benefits, as I said earlier. If they were discharged with disibilities related to military service, then they are entitled to VA benefits, as I said earlier. If they are none of the above, then they are probably misusing VA benefits, and are probably in violation of federal law.
I do know what I am talking about. Ripping off the government, read taxpayers, is rampant in both VA and medicare/medicade. Just because you see cabinets full of VA labled drugs does not make them legally gained.
The one part of this so-called drug benefit plan” that irks me, and shows just how irresponsible the republican led congress, as well as the present administration is, there is no bargaining with drug companies, period. It is not allowed under the plan, ergo, drug companies can charge anything they want.
Closing Canada’s borders to drug purchasers really hurt a lot of people. That was done solely to appease the drug companies and had nothing to do with the quality of drugs, as this administration tried to have us believe.
While this plan is better than nothing, but not by much, it is a long way from giving people in this country the health care they deserve. After all, we are to wealthiest nation on the planet. Just ask all the filthy rich who have their tax shelters off shore.
You may be frustrated with red tape, but the average tax payer in this country is really tired of getting it stuck to them by an administrati0on and congress whose only job, it seems, is to pander to business.
If that makes me out of line in your book, than you’re in the wrong line.
JMThe “bargaining” is done between the Insurance Companies and the drug companies.Since when does the government do a better job of bargaining anything than private enterprise?There is a “rebate” section in the disclosure form of any “Part D” application kit or benefits package.Please read that section.”Rebate” is another name for “bargaining.”Also bargaining happens when the Part D insurance company lists the drug as either “preferred” or “non preferred” in its formulary.Bargaining also happens when the Drug company and the Insurance Company negotiate prices for 90 day supply mail order purchases.I have had problems with this system, but I work with SEVERAL confusing government programs, they all have problems.We are not even one year into Part D.Social Security, Medicare, Medicaide and VA all have administrative problems, but on balance they do more good than bad.Same with D.Give it a chance ok?
JRCanada drug of Kansas is still in business isnt it??I just talked to “Alex” at Canada Drug of Kansas, 945-6337.They are still in business, located at 352 S. West Street in Wichita.I buy my allegra through them, it is cheaper than running it through my insurance and I am an insurance agent!Sometimes, Allegra has a rebate coupon in the mail, then it is cheaper at the pharmacy.Shop, folks.What makes US drugs so expensive, in part, is that other countries are used to shopping for drugs, while Americans, for years, paid no attention to price.That, and the fact that class-action lawsuits against drug companies are illegal in Canada.
I confused my JR response and my JM response, above.My apologies
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What the heck?