Medicare Part D = Oh Oh, Here it Comes!
After attending a recent conference all day this week about the changes that are coming from the introduction of "Part D" in Medicare, I am left with the impression that these are NOT good for the consumers yet all good for the medical profession, large corporations, and pharmacies. There is an introduction of "privatization" turning into practice for this large government program. If such is going on now (having been enacted to law in 2003) and the required changes go into effect for ALL who receive it on January 1, 2006, there is a sad harbinger of future events to come. Learning as much as you can about this, and spreading the word is essential to advocacy that must grow to influence some of the destructive elements of this politically-inspired "reform".

Two examples of this system change will demonstrate just a bit of this reform that does not bode well for the benefit of the consumer. The law was written to accommodate big business and powerful lobbies. See below:

1. ALL Medicare recipients will be required to enroll in one of many "plans" for their prescription coverage. If existing consumers do not make an informed choice, they may be rolled over into any random company's plan. This appears to be similar to the phone companies whose "long distance carriers" may be switched without you knowing. For those who are in the categories that will be able to make a choice, it is IMPERATIVE that the choice to enroll be in the "Initial" enrollment. After the Initial enrollments, there will come more and more penalties month by month that are heavy, for those that choose a plan later on. Essentially one must enroll in a plan without having enough knowledge about what each plan covers!

2. An example given to explain how the new reimbursement system works for the businesses and the insurance industry:

- private insurance may now "insure you" for prescriptions only, not for anything else in health and medical coverage. This benefits those who formerly could not get insurance privately at all.

- private insurers and pharmacies are now paid very substantially to provide your prescription. The government will reimburse them at a huge rate, described as "they give you a pill, they get $100 each time you fill your prescription". Private insurers will now "court" Medicare recipients. AND, did you know that the co-pay, co-insurance and actual formularies each company offers may change at will, without notice to you? The cost may change WEEKLY even, written right into the new reform law! Thus one could sign up for what seems like the best company for you (as determined by what they offer for covered brands of medications) and then they can decide to withdraw your particular medication from their coverage!

There are so many elements of the effects on both Medicaid and Medicare recipients that this will take some time to sort out. Next post will detail some more hidden information that the public will want to know to make informed choices. Stay tuned.
- posted by BJ @ 8:53 AM |