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Medicare Part D 2008 – Please Not Again

·1176 words·6 mins

Does anyone but me have this feeling of impending doom about the first of the year?  For those not in the know, a whole bunch of Medicare Part D plans are changing/merging/switching/etc as of the first of the year.  I know that HealthNet (I think its HeathNet) is switching processors, and there are about 4 or 5 new plans to replace the 4 or 5 that are going away.  People are getting switched around, new cards issued which means new ID/Group numbers (if they have the card AND its printed correctly).

It’s going to be hell all over again.  New cards, down systems (*ahem*Argus*ahem*), confusion, copay changes, formulary changes, hour long help-line hold times, everything hitting us all at once.  The Medicaid/Medicare people are getting auto-switched into new plans, there are confusing letters flying all over the place along with salesmen who will promise golden turds to any senior who will sign on the dotted line.  Add onto that a system that is horribly complex and confusing thats targeted at the population segment that is confused by the most simplest things.  Breaking out the booze yet? 🙂

I hope after the first I quote this post and say “You know, I was wrong, I was really wrong”.  Somehow I don’t think that will happen.

However, aside from all the lost reimbursements, forwarded medication, confusion and swearing, we will again show the rest of the world that us retail pharmacists are the most stubborn, determined, hard working and just outright relentless healthcare professionals out there.  We are the glue that holds the industry together.  Its times like these that retail pharmacists and their staff show their true colors to all of their patients.

I can’t speak for all the retail folk out there, but I know there is a good majority that sat there after Jan 1st of 2006 and 2007, looked deep down into that tall glass of booze, and felt a sense of pride in their profession that wasn’t there before (or it might of just been gas, or psychosis setting in).

Comments #

Comment by The CookieMaker on 2007-12-11 22:35:54 -0800 #

I work for one of the big insurance companies. I am one of the front line people answering peoples questions on the phone. (that is read as “Hi Call me Heather”)
I have to say that if it weren’t for the fact that they give us tons and tons of training each year on all the new changes I would be lost. I know I spent 30 minutes on the phone with one lady only to have her tell me to call her daughter and explain it to her because we weren’t getting anywhere. and that was just trying to explain the gap which she has had in her plan for 2 years now.
let me tell you I feel really sorry for anyone who doesn’t have a patient daughter.

Comment by RJS on 2007-12-12 06:14:33 -0800 #

Can’t say I’m really worried. We have this tool that uses a social security to get us a BIN, a PCN, an ID, a person code, and a group code. Plug that nonsense in and you’ve got a paid claim. It works most of the time.
I don’t work for an independent, so I don’t have to worry about the backend reimbursement, but if I did, I’d probably share your sentiments.
I don’t think anything could beat January 2006, though, when Part D first went into effect. No one but AARP/UnitedWealth Care had their shit together. I think I wanted to machine gun every senior that walked in the door for the whole month.

Comment by Suzy on 2007-12-12 06:19:53 -0800 #

This is off topic, but where are all the links to the other pharmacist blogger websites? The only time I would read those is by linking to them from your website.
Can you put them back up?

Comment by one_angry_tech on 2007-12-12 17:19:08 -0800 #

Yeah, I got me some paid “Medicare Part D Expert Training” at work.. 2 hours listening to the pharmacy trainer drone on from a textbook.
All I know is, you find the least suckable plan, and when gap time comes in, my ass is staying away from drop-off and pick-up. Those seniors can get brutal.
I still don’t know what the fuck I am doing, so…
Go CVS~! :/

Comment by AZ Pharmer on 2007-12-12 17:23:10 -0800 #

I sure hope it’s not bad, everyone has gone thru this a couple times now and hopefully the major problems won’t arise. That being said I’m in for a week of vacation starting after my shift on 12-31 🙂
Nothing will ever be worse than 1-1-06 though, all of the dual eligibles and state medicaid help desks that were that were clueless (common reject was ‘drug not covered’ even on basic cheap shit…turns out that was their way of telling us they were enrolled in MedD), horrible wait times (I placed a call on hands-free at 6pm with United and it was still on hold in the AM Monday), our own corporate IT jerkoffs touting their automatic lookup system that turned out to be worthless as tits on a boar. And to top it all off it was a Sunday!!! Yep, add the first of the year to my list of days I will not work (along with Monday after T-giving and my birthday).
Love your work,

Comment by EEJ on 2007-12-13 12:32:36 -0800 #

Oh, God. I can’t believe I’m doing this.
I normally hate people who send in corrections to stuff, but I can’t get around the fact that you keep typing “might of”, when I think you mean “might have”.
I’m sorry for poking my nose into your grammar, as I love the site and your posts, but that one little thing is bugging me, especially for someone who seems as intelligent as you appear to be.

Comment by limari on 2007-12-14 20:08:43 -0800 #

Oh, God. We get the annual “How to make sense of the mess that is Med D” training , too. The PIC calls all us grunts…(umm..make that pharm techs) together and tells us that we will have to watch the latest “training” DVD on the rickety laptop in the breakroom.
Two at a time, we sit down and try to look interested as the talking heads on the screen drone on about co-pays and adjudication and the dreaded “donut hole” and..well, you know.
The only good thing about these little training sessions is the short-lived relief we get from the facility nurses ( I work in LTC) who call all day long to ask us (in broken English, of course), why Mr. Fred’s scrotum is still red and itchy even after the application of copious amounts of Nystatin cream (“Pharmacist’s call on line 535!!!!”)or how to spell “Megace”. Jeez!
And after all is said and done, and we’re shooed back to the pharmacy floor, we STILL don’t have a clue about the mysterious workings of Med D. We just punt.