Taking steps to correct Aetna drug plan errors
News and views from Rita
Happy Shortest Month of the Newest Year!
To those of you who bought the Medicare Part D Prescription Drug plan, I am sorry to tell you that there was incorrect information about pharmacies who participated in Aetna’s 2015 Part D website during the open enrollment period.
Community pharmacists and beneficiary advocates say that the situation is problematic but the National Community Pharmacists Association called the situation a “bait and switch” on beneficiaries.
Centers for Medicare and Medicare Services (CMS) says that Aetna submitted incorrect information to the agency for Aetna plans and Aetna sent a letter out to pharmacies saying that the information was corrected by Dec. 22, after open enrollment closed on Dec 7. A CMS spokesman says that the agency is aware of the situation and has entered into a mediation plan with Aetna, which includes notifying pharmacies and is calling existing enrollees in Aetna and Coventry plans, who got a prescription within the last six months at an affected pharmacy. CMS says that this affects about 5,000 beneficiaries.
Aetna will also reimburse beneficiaries who go to a pharmacy that was incorrectly listed as ‘in-network’ one time during the first 90 days of the plan year. Beneficiaries will have to pay the full price up front and Aetna will reimburse them so that they pay at an ‘in-network ’ level.
CMS said that a special enrollment period will be offered on a case-by-case basis if beneficiaries call 1-800-MEDICARE.
Better Social Security customer support?
Social Security opened a new National Support Center (NSC). The state-of-the-art data center is more modern and energy efficient with enhanced disaster recovery capabilities and will meet the agency’s anticipated IT workloads for at least the next 20 years. The NSC meets industry and federal data center standards.
The NSC maintains demographic, wage and benefit information on almost every American. The new facility will replace a previous data center and allow the agency to take advantage of modern technology. Construction of the new facility was made possible through $500 million in funding from the American Recovery and Reinvestment Act of 2009 and was delivered on time and under budget.
Excellent reasons to get on the Internet
If you are a computer user, and are disabled or know someone who is and needs help, please go to http://www.Disability.Benefits.gov for information. This section provides a broad range of resources about Social Security disability benefits and assistance programs and services for people with disabilities, seniors and their families. In addition there is a guide to financial help for low income individuals and families.
If you are not computer literate, please try to get someone to help you, as there is much really good information to be had on the Internet on most government websites. Be cautious, though, and do not give out your Social Security number or birth date.
My own favorite website is http://www.benefitscheckup.org and I advise everyone to go into this program, answer a few questions about your assets and home living expenses, and it will come up with every program you might be eligible for and how to apply for any program.
For the record
I received a letter from one of my readers that was filled with misinformation and I wondered how many people were living under these same misconceptions.
“... The Obama administration agreed that the final legislation of the Affordable Care Act would not include any Medicare Prescription Drug price controls.”
The fact of the matter is that George W. Bush (at the behest of his pals in the drug industry) made sure that Medicare would not be able to negotiate drug prices with the drug industry. President Obama had nothing to do with this and in fact was not even in Congress when that bill was enacted.
I am still looking for a compassionate person, who is more than willing and has the time to assist me and learn about the things I do for people who really need help. Money is not a primary issue of their needs – information is what they seek.
If money is not an issue in your needs, please make an appointment with me and you will learn about the personal satisfaction you will get when you help others.
Rita Hatch is an Older Persons Action Group board member and volunteers for OPAG’s Medicare assistance program. Call her at 276-1059 in Anchorage or toll-free statewide at 1-800-478-1059. Her email address is email@example.com.