Medicare's Part D Website: Capacity Problems and Failure

by Tim O'Brien

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Maybe you sat down to help grandma sign up for the new Medicare Prescription Drug plan this year? If you and gramps ended up staring at a HTTP 500 response code, you weren't alone. The Medicare website, a mishmash of Microsoft ASP and ASP.NET pages, has been overwhelmed by activity, and, from most reports, is suffering from frequent outages. Read on...

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Charles Mitchell
2006-04-04 19:50:47
I guess their website reflects other problems they are having, all of which involve mismanagement. Some of the news i have been reading on this medicare news blog for instance makes it pretty evident that technology isnt medicare's only pitfall
Gene Adair
2006-05-09 16:08:36

May 8, 2006

Someone needs to do something, perhaps you can help.

The new Medicare Drug plan is a disaster! Most people seem to think that it's a result of all the old people on Medicare being empty headed but that is not so. Here is what really happens:

You pick a plan that seems great since it has the drugs that you use or an equivalent on its formulary list and you enroll. I enrolled in Mutual of Omaha. They use Caremark for drugs. Now you get a prescription from your physician, which requires an office call. You get that and submit it but weeks later you find out that your physician has to get prior approval. You are told that prior approval requires only a simple phone call from him but later you discover that isn't true either. What he must do in cases when the drug is expensive even though you have been taking it for years is start you on a lower cost different treatment for a while and if that doesn't help, try another still lower cost drug and only if that doesn't work and if he provides copies of your medical records you may get the drug. But that's only if they haven't removed it form the formulary list by that time.

In my case I have suffered from GERD for several years and have had medical treatment for it. My Gastroenterologist (sp?) had prescribed Prevacid, which I had been using for several years. I was told that I would have to take it for the rest of my life when the doctor prescribed it.

The Plan I accepted in January did not have Prevacid but it had Nexium, which I assumed would be equivalent. I went to my Physican, who said that Protonix would be better than Nexium. I got my prescription and mailed it in. Weeks later we called since I had received nothing. First we were told that my prescription was lost since my wife and I both mailed in prescriptions in the same envelope. We assumed that pharmacist would read the prescription. Anyway, it turned out that the prescription wasn't lost, they just wanted some time so they could remove Protonix from the formulary list. In order to get the time they needed they required that my physician try something else first as well as fax my records. After several phone calls about the faxes which somehow never get through according to the drug company, they finally mailed me a letter stating that Protonix was no longer on the formulary list and would not be provided.

All during this time, I'm suffering from chest pain, trying everything I can of OTC medications and swigging the pink stuff. Only managed to stay out of the ER by taking left over ulcer medication from an earlier doctor visit.

Finally we realize their game so after another office call, we have a prescription for Nexium and thanks to our blessed physician a bag of samples to maybe hold me over until the Nexium arrives. Guess what, it turns out to be a repeat of the same sorry story, they have removed Nexium from the formulary list. My physician told my wife that they had as many as 19 rejections in one day from such companies and they were no longer trying to work with them, as they couldn't afford it.

Now I have dropped that plan, which by the way was from a well known and reputable insurance company, and am going through the waiting period of one month after enrolling in another well known and reputable insurance company's plan before they will provide service. This time I enrolled in Humana. I can only hope this plan is better than the first. It is now May and it looks like I will not have my much needed medicine until sometime in June, maybe.

Here is what should be changed:

The provided should only be able to remove drugs from the formulary list if the FDA says they are unsafe.

The physician's prescription should be sufficient to bypass the cheaper drug trial plan. Generics would be okay if the physician approves.

The physician should not be required to copy and submit patient records. They are already overloaded.

The patient should be able to get a prescription for more than one month's supply thereby being able to use the mail-in service and save money for all concerned. All the expensive drugs have a 30-day limitation.

The one-month waiting period before you can submit a prescription is also a serious drawback as that means probably a two-month wait before you can get drugs.

Gene Adair
2017 Beam Rd.
Columbus, IN 47201

Tom Smith
2006-07-20 21:02:41
The Medicare website is joke. Even if you a web savvy twenty year old you simple can not get accurate results.

Gene (if you chance to read this):
When dealing with Humana try to get everything in writing ASAP. Call back to confirm and take down names and dates you spoke to anyone. Like your old plan, they change the formulary list and demand special approval of drugs they say they cover. They also make a lot of mistakes and lose the paperwork and "forget" what they tell you on the phone.

2006-07-21 19:41:22
All I have to say is I am out of medicine August 1 and not sure what to do. I called Wyeth and they told me to get an application and send a letter explaining why I am out of medicine and request the patience assistance program. Since I had been on all free medicine before Part D, I am hoping they will continue this for me. I never thought I would live to see the government mess up like this.
Tom Smith
2006-07-22 17:09:41
The current government would like shut down Medicare and Social Security. The way to do this is without angering the public is to throw as many "wretches" as possible to prevent the smooth running of these plans and say see it doesn't work. Stuff like this did not happen when when Medicare first became active.

This is also a great opportunity for the politicians to make some money on the side from the drug/insurance companies.

Something else doctors no longer have samples to give patients.

2006-10-19 14:28:47
For folks who don't qualify for Medicare but would like to have a discount card, there's a great one at Prices posted on the website. Low membership fees. Check it out!!