Safety net protecting seniors moving to Medicare drug benefit
NASHVILLE — More than 500,000 Tennesseans have enrolled in the new Medicare drug benefit program, but the process hasn’t been as smooth as state agencies had hoped.
Since the drug program took effect Jan. 1, thousands of poor senior citizens and the disabled have had problems understanding the complexities of the new program.
To give some people more time to switch to Medicare drug plans, the state is using the TennCare safety net — initially set up to help people who got kicked off the state’s health care program for the poor, disabled and uninsured.
The safety net provides people who were kicked off TennCare earlier this year with free generic drugs until June 30. Anyone who qualifies for the Medicare pharmacy benefit will get the same coverage until the end of February.
Medicare eligible people were scheduled to have their TennCare medication coverage cut Jan. 1, but state officials realized that wasn’t enough time for people to figure out the best pharmacy plan.
Many eligible people have still not chosen a plan among the 41 available in the state to suit their individual medications, said Andrea White, spokeswoman for the Safety Net program.
“The reason we offered this extension is we wanted to give them ample time to enroll in a Part D plan,” White said.
Since Dec. 15, 580,000 prescriptions have been filled through the safety net program, which is contracted through a private company, White said.
“We estimated 50-70,000 people have used the pharmacy plan,” White said.
Jason Greene, a pharmacist at Reeves-Sain drug store in Murfreesboro, has seen the Medicare drug problems firsthand: patients who are not activated in the system, incorrect deductibles or people on the wrong plan.
“This can be difficult, especially for people who have trouble remembering even to take their pills every day,” Greene said.
At a Medicare seminar at McKendree Village, a senior living facility in Hermitage, people recently got a crash course in the drug benefit program from the State Health Insurance Assistance Program.
“I’ve got to sort it all out,” said 64-year-old Jimmy Dewese from White House. “I don’t know what plan I can afford at this point. Everything is more expensive. Premiums are going up, but my income is going down.”
Lisa Burkett, who works at McKendree Village, attended the program to help her husband figure out the benefit plans.
“For people who don’t have help, don’t have family or friends to explain this program, they’re worried and they’re scared,” Burkett said. “The guesswork is frightening.”
Problems have even come up for the people covered by TennCare who were automatically enrolled in the drug benefit by the federal Centers for Medicare and Medicaid Services.
The CMS reported Monday that 212,000 TennCare enrollees were automatically moved onto the pharmacy benefits program between Nov. 15 and Jan. 13.
TennCare spokeswoman Marilyn Elam said about 25,000 of those auto-enrollees were medically needy and would now be receiving all of their medical coverage through the federal government.
Lucy Utt, community services supervisor with the state Commission on Aging and Disability, said the problem was that CMS randomly assigned them to pharmacy plans.
“We came to realize that the plans to which they were assigned were random and sometimes didn’t cover the medications they needed,” Utt said. “There have been a lot of people who left the pharmacy without their meds.”
Tara Shaver, assistant director of community outreach at the state AARP, has heard from members who didn’t know what plan they were on, or didn’t even know they had been auto-enrolled.
“All of that information may not have been disseminated to the public,” Shaver said.
But Shaver said that most of these problems were fixed within a couple of days either through the pharmacy or through phone calls to CMS.
“Within about a week, we’ve seen people contacted by pharmacists correcting the problem,” Shaver said.
Utt is confident that most of the problems that have resulted from the transition to the federal program will be resolved with time.
“The calls seemed to have slowed down a bit since Jan. 1,” Utt said.
Greene, the pharmacist, said he’s been selling three- or four-day supplies of medications to patients until the problems can be fixed.
“Everyone knew it wasn’t going to be a perfect transition, but day-by-day its been getting better,” Greene said.